Thursday, August 28, 2008

"You never count your money when you're sittin at the table." Kenny Rogers

Now evry gambler knows that the secret to survivin'
Is knowin what to throw away and knowing what to keep.
cause evry hand's a winner and evry hand's a loser,
And the best that you can hope for is to die in your sleep.

Kenny Rogers

My blood tests from last Monday (day 55 after transplant) showed no leukemia in my blood (YEAH) but my engraftment status was unchanged. I am still mostly me and only about 28% donor, which is almost unchanged from last month and while this is very unusual, it is not unprecedented. An eventual albeit painfully slow cure is still my most likely outcome. My doctor does not seemed too worried so I will try not to be.

It is not bad news in any way, it is just not the good news I had hoped for. It means simply more waiting. Now the CT scans and bone marrow biopsy in 30 days are my next signposts. No cancer is no cancer is no cancer, but until my bone marrow is 100% donor, or a few years has gone by, I will have some reason to worry, but not to despair.  The next set of test are to assess my disease status, which is really the crux of the matter. The primary goal of the transplant is not to engraft fully. That is only a means to the end, the end being a cure. If I I remain forever chimeric (mixed donor-host) like others have before me, but my tests show next month  and continue to show that I have and no leukemia anywhere (not just none in the blood, but also none in the bone marrow and nodes), I will have the best of both worlds: a cure without any serious graft versus host disease. That is the holy grail of transplant medicine.

It does mean more waiting without a clear answer.  Probably at least 2 years, unless my engraftment suddenly takes off in the right direction. This is tough for me. But I will keep my best poker face and I be always reminded to "never count your money while you're sittin' at the table. There will be time enough for countin' when the dealin's done

And while the "dealin" is hardly done, thank G-d, I also know that "evry hand's a winner" and I will try to play my very winning hand with finesse and grace.


Blogger Lea Morrison said...


When I was at the Hutch they said the "chronic" leukemias work at the same rate of transplant which was a good thing- slowly.
I think both you and your doctors have a great perspective- you are leukemia free. I have read many posts of very healthy people post transplant that are always mixed chimerism.
Keep on keepin on!
Lea Morrison

August 28, 2008 at 4:49 PM  
Blogger Surgeon General said...

Hi, Brian. I know you'll hang in there all the way to 100%.

I know what you are made off already.

Take care and enjoy. You know how to mdo that already!

August 28, 2008 at 11:26 PM  
Blogger Unknown said...

Hang in there. Two years now and then 50 years later is a good deal. I would take it, run and not look back. In my opinion, you are doing great.

August 29, 2008 at 12:40 PM  

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