Monday, June 27, 2011

Preliminary results

The preliminary results of my bone marrow biopsy from 6/20 showed no leukemia. I won't know anything about the flow cytometry for a few more weeks. As for the cytology study, the results are still a few months away. It was the cytology report from March that showed the strange translocation, and so it is the current cytology report that we're waiting on.

Chris is still suffering from the car accident. Interactions with the at-fault driver's insurance company have been difficult. As of this moment, nothing has been resolved. We've retained an attorney, so I won't be discussing the event on the blog. When I'm able to say something, I will post.

Tuesday, June 21, 2011

Stumping my poor doctor

My life has been a bit more full than I would like this month. I'll take pity on you all and only talk about the last few days. Friday, June 17, Chris was in a horrible car accident. While Chris was driving in to work, a man in a super-duty pick-up truck drove through an intersection and hit Chris' car right in the driver's side door. The other driver did not have the right-of-way and drove across 2 lanes of oncoming traffic and through a median. The impact caused Chris to hit his head against the pillar between the driver's side and passenger window. He was taken to the ER and had a CT scan as well as X-rays.

I got to the hospital while he was out getting scanned. He was discharged a few hours later and has been recovering since. There's still a bump on his head and he continues to get headaches in addition to being sore all over. Thankfully, he didn't break any bones.

We're in the process of dealing with the other guy's insurance and that's all I have to say about it. I'll keep everyone posted as to Chris' recovery.

As for me, I had a few appointments in Houston on Monday. One was a regular check-up with my transplant doctor. The other appointment was for some testing related to my transplant, but having little to do with leukemia. I haven't blogged about the issue, and am sorry for being cryptic. I'll post about it in detail once the test results come in and I have a better understanding of what's going on. All I know is that it's not life-threatening and so you shouldn't worry.

The cytology report from the bone marrow biopsy I had done in March was finally available. My doctor had ordered several molecular studies that are routine when dealing with bone marrow transplant survivors. Some of these tests take days, most take weeks, and some, like the cytology study, can take months.

The FISH test showed no leukemia clones with a MLL gene rearrangement. Clone cells are effectively the little buggers that kick off the whole leukemia process The clinical flow cytometry study was negative for minimal residual B-lymphoblastic leukemia (this is the type of leukemia I was originally diagnosed with).

I rarely go into this much detail when sharing results, but felt it was necessary so that you all could put the next set of results into perspective.

The cytology report showed an anomaly. 20 cells were studied. Of those 20, 19 were diploid female karyotype 46, XX. This means that they were normal, female and had the correct number of chromosomes. 1 cell was determined to be pseudodiploid metaphase 46, XX, t (7;11) (q22;q13). Fundamentally, this means that the cell was captured in the midst of development, that the correct number of chromosomes was present, that it was female, and that it had a translocation of the number 7 and 11 chromosomes.

Generally speaking, a translocation occurs when portions of the chromosome swap places. That's a quick and dirty definition and doesn't encompass the whole of the process. To further put things into perspective, my original leukemia included a t (4;11) translocation which meant a transplant was my only hope.

Before yesterday, I'd never heard of a t (7;11) translocation associated with ALL. Dr. K. explained that it simply doesn't happen with my form of leukemia. My transplant doctor was very thorough in explaining what this finding could mean. She believes the cell was an artifact, meaning that it was a one time occurrence. The cell may have been created during the process of testing. For the sake of due diligence, another bone marrow biopsy was scheduled for the same day. She wants the same tests performed to see if another cell with a t (7;11) translocation appears.

If it does show up again, I'll be monitored. I'll probably start taking maintenance chemotherapy if it does, but that's not certain. As my doctor explained it to me, there are no studies to guide any treatment. I got the impression that the transplant doctors that discuss my case would be making it up as they went along.

That is the worst case scenario.

I want to stress that my doctor felt that we weren't going to have to go there. I believe her. I can tell you that I feel well. I don't have any of the symptoms that were present when I relapsed in 2008. I'll even go so far as to tell you that the cashier in the hospital cafeteria gave me an employee discount because she thought I worked at the hospital. She didn't believe that I was a patient. When strangers mistake you for a hospital employee rather than a cancer patient, you want to do a little dance, because it feels like you just regained your normal badge.

To further put everyone at ease, here are my blood counts, including normal ranges:

White blood cells: 8.8 K/UL (4.0-11.0)

Red blood cells: 3.88 M/UL (4.00-5.50) It's low, but most transplant patients have a hard time with making red blood cells. The only transplant survivor who I know that has a regular red blood cell count is Nancy and she just celebrated her 5th year post transplant. Love you, Nancy.

Hemoglobin: 12.1 G/DL (37.0-37.0)

Platelets: 414 K/UL (140-440)

Absolute neutrophil count: 6.56 K/UL (1.70-7.30)

My counts are essentially normal. When I had cancer, my white blood cell count was phenomenally high while all of my other counts were close to nothing. The same held true when I relapsed. I believe my doctor when she tells me that this new translocation is probably an artifact. I won't know for sure until the new cytology study is done. I won't have those results for a few months. Until then, I'll continue to monitor myself and check in with my local oncologist.

One more thing to help put this into perspective. My next appointment with my transplant doctor at MD Anderson isn't for 6 months. If she was anxious about anything, she wouldn't have given me such a long break between visits.

As for the other health thing that I'm being so cryptic about, the specialist I'm seeing will have the results in a few weeks. I'll disclose everything once I have the information.

Saturday, June 11, 2011

Dori

Most of my regular readers will probably know that Dori Brown was stolen by cancer this week. I say stolen because I still believe cancer is the worst kind of thief, indiscriminate and indifferent to its victims and their families.

If you haven't read her story, you can find it here and here.

The first thing you might notice when you go to either site is her unbelievably bright smile, or maybe you'll notice the warmth in her eyes. I was lucky enough to meet Dori in April and I can honestly say her pictures don't do her justice. She was so much more vibrant in person. For lack of a more poetic description, she was just so Dori.

I've wanted to write something to honor her since I learned the horrible news, but my heart has been filled with tacks and the words refuse to come.

Dori was an infinitely gorgeous soul who touched every single person she came into contact with. I came to love her through her sweet husband's beautiful writing and meeting her in person only served to solidify my belief that she was one of those very unique individuals who instantly inspires love.

My heart hurts for Jim and their beautiful children, and I wish I could write something more fitting, but I just don't have the words.

Saturday, June 4, 2011

Milestones that don't include cancer

Today, Chris and I are celebrating our seventh wedding anniversary. Not in a hospital. Free of cancer. At home. It feels good to be able to say those things.

Happy anniversary to the love of my life. I wouldn't be here today if not for him.

Friday, June 3, 2011

Help PJ

My friend PJ is running the New York City marathon to honor our mutual friend Dori. PJ's a member of the 2 time transplant club and an all around amazing person. She's training for the marathon through Team in Training, affiliated with the Leukemia and Lymphoma Society. Please donate through her TNT page to help support cancer research and provide services for the many patients in need. Do it for Dori.

Here's PJ's latest post with website information:

Help Me Blood Cancer Patients

I'm running the NYC Marathon in November to raise funds for Team in Training, specifically in honor of Dori Brown. Please pass on this message to anyone you know who is able to help this cause, our cause.

Thanks for your help.

http://pages.teamintraining.org/nyc/nyc11/pjempty