BMT vs chemo alone

Today is exactly four months since I was first diagnosed with AML-M7.

I had yet another bone marrow test and bone biopsy done this morning. Although the doctors didn't get me to sleep with double the sedation dosage, I was pretty zonked out and was rather cooperative in that I didn't wriggle too much during the procedure. The results of the tests will be known later in the week and I hope I am still in complete remission.

The term "complete remission" is defined as "less than 5% blast cells remaining in the bone marrow". Blast cells represent about 1% of normally developing marrow cells. In acute leukaemias, blast cells, similar in appearance to normal blast cells, accumulate in large numbers. Unfortunately, there is no knowing if 100% of the leukaemia cells have been destroyed since there is no test which can perform this task.

My transplant doctor says if I have chemo only, my chances of a cure is only about 15%, compared to near 50% if I have a BMT since I have high-risk leukaemia. Of course, my oncologist thinks the odds are more equal (both about 50%)! In any case, the benefits of a BMT are three-fold compared to going through conventional chemotherapy alone. First, an even more intense pre-conditioning regimen is prescribed. (A BMT serves as a method to restore normal blood cell production as the bone marrow can be permanently damaged when more intensive and larger doses of chemotherapy are administered.) The drugs have an anti-leukaemia effect so hopefully, all the remaining diseased cells will be killed. Second, should there be residual leukaemia cells, the graft-vs-leukaemia effect (this happens when the graft [donor's blood] attacks these diseased cells) will make it less likely that the maglinancy will return after transplant. Third, in the conventional chemo, the drug which I would have to be given to try to remove any remaining leukaemia cells is known to substantially raise the risk of serious heart damage (irreversible) which can appear later in life.

So that is why I am going to have a BMT even though it comes with its own serious risks.

Andrew and Jo, Daddy doesn't remember Mt Rolleston so well (that may have been from the six-pack of beer), but he does remember another incident when he was a teenager. Uncle Stephen and him stopped the car (also on the road to Arthus Pass), and seeing a reasonable-looking hill on the side of the road said, "Let's climb to top of that one". The hill's name turned out to be "Mt Horrible" ... and true to its name, what looked easy quickly turned nasty as Daddy got stuck on a rock face not being able to go up further or come back down. Well, my Dad is still here, so I'm keeping my fingers crossed that I too will conquer my mountain.

Speaking of climbing ... Simon, I have discovered what great fun it is to walk up and down big steps (even though I can't walk on my own) over the past week and I can't get enough of it, although everyone else is complaining of back pains from supporting me under my arms (I try very hard to brush their hands off but they wouldn't let go)! Well, once I begin to walk, everyone will have a tiring time trying to keep me within my boundaries (of my very clean mat)!