I got a phone call today from Kate, who is the co-ordinating nurse. She had some good news for me. Last week I got a bone marrow biopsy, and we have been waiting for the test results. There is zero lymphoma in my bone marrow. Does this meant that I am cured? Probably.
I wish that it definitely meant that I am cured, but biology is pretty subtle. I had a bone marrow transplant to get rid of my stem cells in my bone marrow and replace it with my donor's, but that does not happen all at once, nor does it happen completely. The ratio of donor cells to my cells is called chimerism, and we are still waiting for the results of that test. We might hear by the end of the week, but it might be early next week.
The possibilities are that my chimerism is high (i.e. most of my bone marrow has been taken over by my donor's cells) and that would be great news. It would mean that I am essentially cured. However, if my chimerism is still low, then I still have a lot of my own cells, and they will eventually start producing cancerous cells again. All will not be lost, as chimerism can take up to 100 days after transplant, and my test was only on day 35. Even if my chimerism is low, the donor cells still could take over.
On the other hand, even if my chimerism is high, my remaining cells might rally in a few years and start taking out my donor cells. I think this is unlikely as most transplants are permanent, but this is why I will have to continue having a yearly biopsy for the foreseeable future.
I still have a ways to go, and I am not out of the woods quite yet. Because I am on immune-suppressants, infection is still a huge risk, but I have passed an important milestone, and am feeling pretty positive about the road ahead.
I wish that it definitely meant that I am cured, but biology is pretty subtle. I had a bone marrow transplant to get rid of my stem cells in my bone marrow and replace it with my donor's, but that does not happen all at once, nor does it happen completely. The ratio of donor cells to my cells is called chimerism, and we are still waiting for the results of that test. We might hear by the end of the week, but it might be early next week.
The possibilities are that my chimerism is high (i.e. most of my bone marrow has been taken over by my donor's cells) and that would be great news. It would mean that I am essentially cured. However, if my chimerism is still low, then I still have a lot of my own cells, and they will eventually start producing cancerous cells again. All will not be lost, as chimerism can take up to 100 days after transplant, and my test was only on day 35. Even if my chimerism is low, the donor cells still could take over.
On the other hand, even if my chimerism is high, my remaining cells might rally in a few years and start taking out my donor cells. I think this is unlikely as most transplants are permanent, but this is why I will have to continue having a yearly biopsy for the foreseeable future.
I still have a ways to go, and I am not out of the woods quite yet. Because I am on immune-suppressants, infection is still a huge risk, but I have passed an important milestone, and am feeling pretty positive about the road ahead.
Great news! Hugs and kisses from all of us! I know it's a long road ahead, but not a bad way to start!
ReplyDeleteXXXOOO
Amazing, the good news just keeps commin' - when do you get to leave solitary?
ReplyDeletePrue
Not until I am off the immune suppressants. If my chimerism is good, we will probably start reducing next week, but it will be at least 17 weeks before I am off the drugs, so sometime in July, I guess.
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