Team Meeting on the Seventh Floor (= No Firm Dates)

Friday - October 26, 2012

Joe and I are spending the bulk of the day at VCU.  First on our agenda is blood work followed by a Rituxan infusion in preparation for Monday's hospitalization and methotrexate.  I suppose that low platelets might once again postpone this plan but ... I'm feeling lucky!  Then we are heading up to the Bone Marrow Transplant Clinic for a meeting with the team about possibilities, prospects, options, and - perhaps! - a proposed plan and schedule.  I'll post an update in the late afternoon / early evening.  Hoping for good news as well as some specifics.  I LOVE a good plan - something to anticipate and build towards ....

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Following our meeting with my physician and my BMT coordinator, I suppose that Joe and I have emerged with an outline of a plan however it's a plan without firm dates.  One thing cancer-treatment should have already taught me is that "definites" are not part of the equation; everything is uncertain and amorphous and that characteristic applies to timelines.  Nicked bladders, neutropenia, and low platelets have all been surmounted in stride over the last six months but all have effected shifts in even my most predictable, well-established chemotherapy protocol. my timetable has been tweaked as we moved forward.

Haploidentical?

Given this uncertain environment, I am still living with some "definites" in terms of my upcoming Bone Marrow Transplant.   First, with my high IPI status, an allogeneic rather than an autologous BMT is advised to best address the chance of relapse.  Second, the odds of finding a third party donor off the register are minimal at this point.  Third, the faster I engraft someone else's bone marrow, the better; I need to be in a state of complete response to proceed to the best outcome.  A great stroke of good fortune exists in that VCU is one of five centers nationwide conducting a clinical trial that allows me access to alternative means of allogeneic BMT - a haploidentical or cord blood transplant.  The uncertainty at this juncture is whether I qualify under the clinical trial's current language detailing participants' inclusion, am eligible now in anticipation of language changes that will be enacted in a January redraft of the clinical trial, or will be eligible in January when these language changes take effect.  I may hear next week about whether we can move ahead now or have to wait until the January redraft is adopted.

More good news:  Jonathan's bone marrow equals Megan's in that they are both a 4 of 6 match for me.  In order to determine who will donate for the haplo transplant, their samples will be tested further for antibodies and viruses that might impact engraftment and graft versus host disease (GVHD).  Time will tell  :)

In the meantime, my blood levels are great, the Rituxan is in, and my hospitalization is confirmed for Monday!  Hurricane or tropical storm, I am checking in and claiming that high-dose methotrexate that is destined for me.  I need it, I want it, I won't wait!