So, the next step in a relapse situation is to form a plan of action. This would consist of a meeting of the oncology minds at the hospital, setting up the consult and preparing myself for what comes next. For what comes next. I had prepared myself three years earlier. It was mental torture. The fear of the unknown and the potential outcome of the transplant was a life or death scenario. As a cancer patient, dealing with the unknown is as bad as dealing with the cancer. Here we go again.
My appointment began as usual. Blood draw, weight check, escort to the exam room and a bunch of questions from unrelenting residents. At this visit, my exam room was a larger version because Dr. Dave would be performing yet another bone marrow aspiration. I can’t wait. It never gets any easier….You just know what to expect. After the procedure we would get down to the business of what comes next. Dr. Dave went about his usual protocol. Walking in with the big stainless tray of big ass needles, it was go time. Grab the top of the table, curl my toes at the other end, feel the huge needle pierce my bone and wait for the big draw. Motherfu#%#$r. This stuff was getting old yet we were starting all over again.
I was given a few minutes to gather myself after the procedure and prepare for the consult. The pain in my hip was just an afterthought. The reveal of my future was minutes away and the only focus I had at the time. What’s the plan Dave? I was on the edge of my seat. Literally. Its hard to lean back when you just got impaled by a freaking ice pick. Anyway, the first item on the agenda was to wait for all of the test results to come back. Aspiration results, Chimerism result, new PCR result and the basic CBC. We already knew that the results were going to show, positive results for CML, but to what extent? The second item was part two of the plan. The DLI.
A Donor Lymphocyte Infusion or DLI would be my next avenue of treatment. This procedure would result in my brother, my original donor, to come into the hospital and undergo a procedure called Pheresis. This would entail having an IV placed in each arm where blood drawn from one arm would travel through a special machine, extract the cells needed for the DLI, then place the original blood back into his bloodstream through the other arm. A several hour long procedure. Not very comfortable to say the least. After processing the cells, I would receive them through an IV drip in another room and hopefully be able to leave as an outpatient barring any major complications. The DLI was supposed to regenerate my brothers donor bone marrow, now mine, to kill off the returning marrow that was my own. We didn’t want my marrow to return. Bad marrow. The Chimerism that was being run would let me know the state of the DNA in my bone marrow soon. Dr. Dave was also running a typing test to see if my blood was going back to O Positive from my current change to B Positive.
This was the grand plan. The DLI would reverse the trend. It would put me back into the desired state of remission for which we all so desired. Again. The course was charted. Two weeks. Let’s get it.
Next Up: Reminiscing