BMT Apppointment and DLI

This afternoon I met with my BMT doctor to get some questions answered about the donor lymphocyte clinical trial that we had been considering. It turns out that my BMT doctor and I were on a totally different page. I was thinking we were talking about a "killer cell" trial, while he was actually talking about doing just a donor lymphocyte infusion. He feels that the donor lymphocyte infusions are more effective and would be more worth the risk in my case. Basically how the infusion would work is that they would collect from my original donor next Wednesday 10/26, the cells would arrive on Thursday 10/27 (yes, from Germany), and they would be infused into me on Friday 10/28. My main concern as well as my oncologists' was stopping chemo meanwhile we do the lymphocyte infusion. I cannot receive chemo at the same time, because it would defeat the purpose of the infusion (the chemo would basically kill all the donor cells). I could still get chemo next Wednesday as planned, but then I would have to take a 4 week break from it to let the donor cells do their thing. The risk I take is that my tumor could start to grow again within those 4 weeks. And of course the biggest risk of all is getting graft vs host disease again. I will remain on prednisone though to try to eliminate that possibility and/or to make it less severe.

The way my doctor explained how the infusion could potentially work is that the donor T-cells from my original allogeneic transplant have now matured and are "tolerant to self." This means that they're most likely not recognizing my tumor as foreign anymore and by giving me some new donor cells they could again see my tumor as foreign and possibly shrink/kill some of it off. Again the likelyhood of this happening is slim, but it's worth a try. So now that I know a little more about what this consists of, how it could potentially work, and all the risks associated with it, I think I've decided to go ahead with it pending my PET/CT results from this Friday. I did find out today that my last chest x-ray did show some growth in my right lung. I knew that when my oncologist told me there was something "funny" showing up, it really meant something bad. The PET/CT will show a lot more detail as to what is going on and will help in the decision of whether we can stop chemo for 4 weeks to do the DLI and/or if we need to move on to a new treatment because this one has stopped working. My BMT doctor promised to email me the results of the scan on Monday. He also did confirm that the chimerism test I had done last week showed that I still have 100% donor cells (which would need to be the case to do the DLI).

Work has been going great. I've managed to work more than 30 hours a week since I went back, so Siebel is reinstating all my benefits, which I'm very happy about. Even though I wasn't paying for Cobra (they were), it's nice to know that when I do have to go on Cobra again I will be able to start my 18 months over. I'm just keeping my fingers crossed that whatever happens with my treatment the next coming weeks/months I will be able to continue working.

This weekend is the Nike marathon that Chris and I had been training for a while back. We're hoping to make it to the event on Sunday morning to cheer on our friends. It will also be a nice distraction for me, since I'll be thinking about the results of my scan all weekend.