Wednesday, December 2, 2009

Tough Stuff Part 3

Thanks to all who emailed or commented on my increasingly neurotic noodling.

Please do share with me your thoughts and ideas. It helps. It can be hard to get outside my own head, and you readers catch details I fly past in my writing.

TomD makes a good point in his comment. As sung by another Tom, his argument was that: This doesn't have to be the big get even.

In other words, delay the chemo and with it, the transplant. Don't drink the poison.

Instead, dance a little with HDMP+R for as long as the sweet music of remission lasts. And by remission, I mean no ITP, which is a strange end point, but my ITP is the driver of this equivocating. HDMP+R has a fabulous 96% response rate and an average 30 months progression free survival. Appears to work with 11q del as well though the number are tiny.

If the ITP recurs in 2 1/2 years, just move onto the next decision point, likely a transplant.

Rai says go for the transplant directly and Forman is not keen on HDMP+R.

Kipps of course thinks it makes perfect sense.

I am so confused. I will sleep on it.



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