Posted by Becky
The results of yesterday's bone marrow biopsy are back. This morning, the doctors were concerned because Leif's spleen and lymph nodes had not shrunk, per the CT scan. However, the biopsy shows that the lymphoma in his marrow has decreased.
Normal bone marrow in a person Leif's age contains about 60% cells and 40% fat. In the biopsy last month, Leif's marrow was packed with lymphoma cells, about 90%. Now there are about 15-20% cells overall, which is better. There are spots of lymphoma cells (about 10%) but it's considerably improved. There are also normal-appearing early-stage cells, which shows that his healthy marrow is regenerating.
Now the doctors will circle up and have a discussion about what to do next. The question is, how little lymphoma do they want to see before going to transplant? They might want to do another round of chemo. I asked whether they are likely to use the same regimen as Leif just got; the doctor said that in light of the fact that the remaining cells appear to be resistant to that regimen, they could choose a different one instead.
In the immediate future, once Leif's neutrophil count hits 500 (it was 240 today) they want to give him a break from the hospital, to go home and recuperate physically and mentally for about a week before either getting more chemo or starting the transplant process, whichever comes next. They will likely make the final plan/decision while he's home. We'd like to go to Belfast and Brunswick at least briefly during that time so Leif can see as many friends & family as possible.
Leif's first question was, if they can get his bone marrow clean with more chemo, will they revisit the decision to use his own stem cells (called an autologous transplant) vs. donor cells (called an allogeneic transplant)? Naturally we are concerned about the risks associated with a donor transplant. The doctor said that while the risk of Graft vs. Host Disease is higher with donor cells, the risk of relapse (i.e. the cancer coming back) is higher using Leif's own cells. So those are the risks they will be weighing as they make a decision. As of now, they still plan on going for a donor transplant.
The results of yesterday's bone marrow biopsy are back. This morning, the doctors were concerned because Leif's spleen and lymph nodes had not shrunk, per the CT scan. However, the biopsy shows that the lymphoma in his marrow has decreased.
Normal bone marrow in a person Leif's age contains about 60% cells and 40% fat. In the biopsy last month, Leif's marrow was packed with lymphoma cells, about 90%. Now there are about 15-20% cells overall, which is better. There are spots of lymphoma cells (about 10%) but it's considerably improved. There are also normal-appearing early-stage cells, which shows that his healthy marrow is regenerating.
Now the doctors will circle up and have a discussion about what to do next. The question is, how little lymphoma do they want to see before going to transplant? They might want to do another round of chemo. I asked whether they are likely to use the same regimen as Leif just got; the doctor said that in light of the fact that the remaining cells appear to be resistant to that regimen, they could choose a different one instead.
In the immediate future, once Leif's neutrophil count hits 500 (it was 240 today) they want to give him a break from the hospital, to go home and recuperate physically and mentally for about a week before either getting more chemo or starting the transplant process, whichever comes next. They will likely make the final plan/decision while he's home. We'd like to go to Belfast and Brunswick at least briefly during that time so Leif can see as many friends & family as possible.
Leif's first question was, if they can get his bone marrow clean with more chemo, will they revisit the decision to use his own stem cells (called an autologous transplant) vs. donor cells (called an allogeneic transplant)? Naturally we are concerned about the risks associated with a donor transplant. The doctor said that while the risk of Graft vs. Host Disease is higher with donor cells, the risk of relapse (i.e. the cancer coming back) is higher using Leif's own cells. So those are the risks they will be weighing as they make a decision. As of now, they still plan on going for a donor transplant.
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