Today they took blood for my next mixed chimerism test. As you will no doubt recall, this is the test to measure ow much of my host blood remains, versus how much is the donor blood from my brother. The hope is that there will be less of "me" than last time, but it is expected that some will remain, and I will probably need to be treated with mature lymphocytes fresh from my brother! This is intended to bring on some more GVHD, and hope fully kill off the last of my potentially cancerous bone marrow. I do not know if the test results will be back next week, if not I will know after Christmas.
They also took blood for a FISH test. This is another way of measuring how much Philadelphia chromosome I have (another way from the BCR-ABL test they did before). The test is less sensitive than the BCR-ABL, so we are looking for a definite negative from it.
I am pleased to say that my blood counts have continued their meteoric rise; neutrophils 3.36, haemoglobin 12.1 and lymphocytes 0.39. It is about the right time after ceasing immune suppression for my lymphocytes to start to rise (they have never passed 0.4 since the transplant). The cause of the drop in neutrophils is still unknown, so I am going to restart the Imatinib (Glivec) at 400mg per day. If my neutrophils drop, then we will know that Glivec is the cause. If they do not, I think we can assume it was some transient infection that caused the diarrhoea, and my neutrophils to drop. I have been on 200mg of Glivec per day, but the doctor said it really needs to be at least 300mg, so if my neutrophils do drop, I will cut back to 300mg, and see if I can tolerate that. If not, they will give me another drug, which I assume is yet more expensive than Glivec, otherwise they would prescribe it now!
I have my lumbar puncture (LP) and intrathecal methotrexate booked for the 28th of December. They will take blood for a coagulation test next Thursday (22nd), and hopefully the pharmacy will release the methotrexate without me having to wait 5 hours for another test on the 28th (like last to time). It is amazing to me that the doctors and the pharmacy cannot agree what is a reasonable period of time between the coagulation test and the LP, but it seems they cannot, so it will be pot luck on the 28th (the doctor said as much today, even though he will discuss with the pharmacy, they never give anything in writing).
I am trying to make travel plans for work; January to Israel and February to the US. Assuming I stay as I am, this will be no problem, but the rather annoying thing is that we never know what might happen. If my neutrophils suddenly drop like they did, or if I get an attack of GVHD, then I think I will have to cancel the travel. I feel that I must assume everything will be OK, and live as normally as possible (of course I do, I am an optimist in this, the "best of all possible worlds"), and I am looking forward to meeting my colleagues again after more than a year!
No comments:
Post a Comment