Ladies and Gents,
Your good efforts whether they be prayers, happy thoughts, hopes, crossing of fingers and toes, whatever they were... you've done well. Tom's biopsy last Monday yielded no leukemia ... yes, you've read that correctly, no leukemia!!!!! Go on and read it again if you like, it's still true! We are absolutely elated to have received such news!
After the previous biopsy's crushing let down, we went in with absolutely no expectations. Nearly cried with the overwhelming joy (but don't worry, we were too cool for that). The oncologist told us that the pathologist looked rather discerningly and found absolutely no suspicious cells! That said, here's what comes next:
While Tom is in remission, the battle is far from over. If things were functioning normally and responding normally, Tom should have been in remission in August. That's why he has to get a bone marrow transplant. Because with chemo alone, even if remission were achieved (like it has been) the chances are very high for relapse. So, they achieve remission and then go forward with a marrow transplant.
Oliver was already determined as not a marrow match. Alex did his test last Monday, so the results ought to be in any day this week. Whether Alex comes back a match or not, it can still take near a month to coordinate things and get the sample collected, etc. Due to such a time frame and the rather high possibility that Alex is not a match and they will need to find a registry donor, they cannot waste any time and need to make sure that they maintain Tom's current remission. This means that he needs to do the same chemo as he did last month, but one less day worth and without the long stay.
Tom mentioned his mom's arrival on Wednesday and asked if he could wait until Thursday to go in. Dr. Carroll said, "Let's do Monday" so that Tom could spend the weekend with his Mom. So, he goes in Monday for five days (assuming he does not get a fever while in the hospital) which in turn means: Tom will be home for Christmas!!!! Sure, he will probably be feeling rather awful (as his counts will then be crashing at home rather than in the hospital) but he'll be here to celebrate the Holiday!!!!
As for the actual transplant. If Alex is a match, Tom will have to re-cooperate from this chemo he'll be doing next week and they will have to collect the stem cells from Alex, so we're looking at mid-late January. The same to be said if Alex isn't a match, but they are able to line up a registry donor quickly. If neither of those are true, they will do more maintenance chemo to retain remission until they do have something lined up.
When things are lined up and ready to move forward with the transplant, they do a different chemo. This other chemo is so strong that it completely wipes out Tom's marrow and immune system, but unlike the current and previous regimen, the marrow doesn't come back. So, they absolutely cannot do this chemo until they have the donor's goods lined up and ready to infuse, as there's no returning Tom's system. The actual "transplant" is like hanging a bag of blood (but stem cells) and takes about 45 minutes.
They then have Tom stay in for about 5-7 weeks as he recovers and they monitor for anything crazy. Upon discharge, he will have to go into the hospital every morning for a few months, to check his levels and adjust his anti-rejection meds (to prevent graph vs. host). If things are good and he attains 100% the donor's marrow, they will begin to slowly let him off the leash.
So, we aren't across the finish line yet, but we have made one gigantic stride in the right direction.
Happy Monday Everyone!