Tuesday, 8 April 2008

New Plans

We had a good update with the BMT team today. Eric had standard bloodwork - we didn't bother waiting for results because he is fine -- no symptoms of low counts at all. Cor, Morgan and I all accompanied Eric today. What an entourage...!

We met with Dr Bence Bruckler to go over the next steps. We are relieved that, while the search for a donor continues, they are not willing to consider an Allo transplant yet.

There is a very promising drug called AMD3100 still in clinical trials that is showing increased success in mobilizing stem cells (even among those they call "poor mobilizers"). From the linked article,
"The rates of successful CD34+ cell collection were similar for patients who previously failed chemotherapy mobilization or cytokine-only mobilization: NHL—60.3%, MM—71.4% and HD—76.5%" (Bone Marrow Transplantation (2008)).

Currently the only center in Canada enrolled in the clinical trial is in Saskatchewan. Dr Huebsch is in touch with the company to try to make this drug available to Eric. Not expecting to have to ship Eric off to Saskatchewan but, hey -- that would be doable if we had to.

We will know the full plan late next week, but we expect that Eric will start the moblization protocol (more Neupogen + the AMD3100) in a couple of weeks and apharesis collection will be scheduled April 29 - May 1.

And we have a plan B too ---- He is currently scheduled for surgery on May 1. If we have not been able to collect stem cells peripherally or if not enough are collected, they will harvest directly from his bone marrow by drilling into his hip bones.

So that gives us 2 more plans to finally get stem cells for his transplant. The great news is that Eric continues to be otherwise healthy. He feels great and there is no indication that the Hodgkins is progressing. The doctors feel that there is no rush to get to a transplant and will take the time they need to get this right. Having that time is indeed a luxury and we are very grateful.

All in all, we came out of the meeting with Dr Bence Bruckler feeling positive - she answered all our questions before we could ask them and presented a plan that we are all happy with.


fionn said...

Hi Kathy - I've posted on Becca's wall as well, but thought I'd post here too. My stem cell collection failed too (I was another young patient - 18 at the time - does that have anything to do with it) and they harvested bone marrow from my hips surgically. As I recall we tried for one day and got a few and then they decided it wasn't going to happen and went straight for bone marrow harvest.

Anyway I was wondering why doctors seem so hesitant about it - like it seemed like a last resort from what you've said. I think the doctors said that cells take a bit longer to come back with bone marrow rather than stem cells, but it didn't seem like it was a big deal when I collected that I had to get bone marrow instead. [The doctors said it happened rarely, but it sometimes did.]

Anyway, just to say that I had bone marrow harvested and all worked well and I'm five years in remission - so it works just as well! All the best to you and Eric!

Adrienne said...

I'm glad to see that you got some answers from your doctor visit and really glad to hear that Eric is feeling well.

Alison (Adrienne's mom)

Kevin said...

Thanks to a great team of supporters. The prognosis is good. I cant really say that I have been one of late but thanks to Kathy (Erics Mom) I have been able to keep up to date. I have never learned so much so fast.

The blood donor registry is not as updated here in Brantford, but all parties are involved in getting it that way.

I am scheduled for another test at the end of April and so are other relatives.

I am very hopeful about you Eric. I seem to feel that everyone is.

Kevin (Dad)