Tuesday - Awake and Well

Trish seemed awake and well today. Aunt Mary came to visit and brought the care package from Luanne to the hospital. The picture frame also arrived today and Trish was very excited to see everyone on the frame. Thanks for sending the pictures in. She told me she would watch the boys Lacrosse game later tonight. Also in the box, were Birkenstocks from MarcO (the boys and I tried to fit the gummi's in but we just couldn't do it, hopefully we don't eat them all before we get up there) and the "special" lotion and lip balm from Sabine and Helmut (Trish's favorites). Today was a very busy day. I can't wait to talk to her tonight, if I can sneak through all the other calls, she's likely to be tired today. Amanda and Dylan our neighbor kids wanted to send Trish flowers, but couldn't so they made her flowers. I haven't seen them yet, but they sure made Trish happy!

There won't be much news till Thursday and than next Monday when Trish has her biopsy and the results of the biopsy. Below is some more info on the transplant from Trish's number one advocate (besides me that is), Dr. G:

The transplant we are planning to do uses two different chemotherapy types. These are Cytoxan (which she is getting now) and another medication called busulfan. These medications are given for four days before the transplant is infused.
Trish's transplant will be from an unrelated donor, so the graft (the transplant) does not get manipulated at all before she gets it. It comes directly from her donor and goes into her.

The transplant we will give her is called a fully matched unrelated donor transplant. Here at hopkins, we are doing all our transplants on a particular clinical trial which involves giving a dose of cytoxan to everyone on the day following transplant. This strategy is designed to decrease the possibility of graft vs host disease which can be so devastating in patients who recieve an unrelated donor transplant. I do not have the data at my fingertips regarding outcomes for the patients who have been enrolled on this protocol so far, but before we go ahead with transplant I will get them for you.

I think it is important to realize that without a transplant people who develop relapsed leukemia have a very high chance of relapsing again if they are given chemotherapy alone, and once they relapse a third time the chance of getting a prolonged remission declines considerably and the mortality is very high. It is the result of this very poor outcome in patients with relapsed leukemia that we entertain transplant as a viable treatment strategy despite the very real transplant related risk of mortality and the very common side effects of graft vs host disease.

I hate leukemia and if there was anything else that would work, I would do that instead. But transplant is really the only treatment option that I have to offer that can give trish the chance at a cure for her leukemia. I saw Trish yesterday and she actually looks really well. She tells me that even though she isn't eating, she feels ok and the second round of chemotherapy was not as horrible as the first one. She tells me that her itching is entirely gone. She is due for her day 14 bone marrow on thursday and I told her I would do it, since she says she would prefer that. I will let you know as soon as we have the results.

Take good care of yourself and the boys, I know you're worried and there is nothing that can be done about that. I'm worried too, but so far, Trish is doing a great job and everything is going as planned. I will keep looking in on her. Don't hesitate to email me if you need something.