Remission Rethink

June 29

After the last bone marrow biopsy on Monday, it appears that the earlier diagnosis of remission was incorrect. Apparently, the blast cells are at 14%, little reduced from before the induction chemotherapy. The earlier reading (just before I left the hospital at the end of May) could have been wrong either because of the lack of aspirate to analyze, or because the blast cells were only temporarily supressed.

Repeat of the inducation chemotherapy does not seem to be a viable option, as it would require a higher dose, be harder on me, and have a low chance of success.

So, a new course of action is happening. This is the protocol that is usually used first for older MDS patients, which is the monthly cycle of azacitidine treatments. This differs from the consolidation chemotherapy that I was set to have in that it is a different drug and requires subcutaneous injections for 7 consecutive days in a month (with weekend off, so actually 7 of 9 - bring on the ST:V jokes), followed by 21 days off. The other difference is that this treatment can continue for an indefinite number of months until a transplant is available, whereas the consolidation chemotherapy could only be done twice.

The outcome of this treatment has a relatively low (about 20%) chance of bringing on full remission, but a very good chance of improving the situation somewhat, or at least remaining stable for many months without getting worse. As I am still pretty healthy on a macro-scale, this should be good enough for the time being.