Thursday, 31 July 2008

Wondering What You Can Do?

Lots of people have asked how they can help...

A couple of suggestions:

- Eric will need lots of blood and platelet transfusions over the next few weeks. The blood supply is always at it's lowest mid-summer. If you can, please give blood. In Canada, call 1 888 2donate to book an appointment.

- He'll likely groan at me for this one.... But, Eric likes getting mail (yep - good ole fashioned snail mail). The MacLeod family will recognize his Grampy in that! Feel free to send a card, joke, magazine to him:

Eric Brule
320 Croydon Ave Apt 610
Ottawa ON
K2B 5P3

Thanks Everyone -- appreciate all your support!

Wednesday, 30 July 2008

Day -8 Done!

Another uneventful day... chemo early in the morning and then we had the rest of the day off. Loving the outpatient option!

Tuesday, 29 July 2008

Day - 9

Eric had his first infusion of conditioning chemo today (Fludarabine 30mg/m2 for you avid Googlers or PubMed afficionados). The purpose of this drug is to clean out his bone marrow and 'make room' for the donor marrow next week. This drug is not expected to have too many nasty side effects but Eric has a good supply of drugs to help counteract any minor nausea. Of course, any minor nausea could also be caused by the lunch at McDonalds.

As we expected, the chemo was quick but the paperwork was long and painful. The idea is that by completing all the admission work today, it will be quicker and simpler when/if Eric needs to stay as an overnight inpatient. I know Eric would love to complete this transplant outpatient, but Mom is sure glad there is a contingency plan in place...

That's it for today - may the next 6 weeks be similarly boring!

Sunday, 27 July 2008

So, What Is Happening?

Over the past couple of months, there has been considerable testing of both Eric and his donor. The BMT team needs to know as much as possible about both so that they can orchestrate the transplant in such a way that Eric's body will accept the new marrow. Fortunately, we have a perfect match. A transplant using a matched unrelated donor is often referred to as a MUD transplant.

Eric is currently healthy -- his Hodgkins Lymphoma is as reduced as the doctor's can possibly tell. Eric's Hodgkins does not present with palpable lumps or any outward signal that it has returned. He has a couple of nodes in his abdomen that enlarge slightly (by millimeters) and then the Hodgkins seems to go right to his bone marrow. So the first indication of further relapse is low blood counts or weight loss. Currently those nodes are stable, his blood counts are high and he is at a great weight. All good signs to proceed to a transplant.

Eric will have what is called a mini or allo-lite or RIC (reduced intensity conditioning) Allogeneic transplant (or if you are googling it -- nonmyeloablative allogeneic stem cell transplant). The reduced intensity conditioning chemo reduces some of the risk around an allo transplant. Allo transplants are seldom utilized for Hodgkins due to this risk. There are no studies to support the suspicion that a mini-allo can exploit the host vs lymphoma effect -- meaning that the engrafted donor's marrow can fight any lingering Hodgkins cells.

No studies, does not mean it is not happening! Obviously, the risk around this procedure precludes random blind trials. What we know is that Eric is an excellent candidate, the match is great and we are working with the best team I could imagine.

Click to enlarge this diagram:

Friday, 25 July 2008

Deep Breath... Ready, Set, Go

We had a planning meeting today (yes, I know we seem to have had ALOT of those) with the BMT team and have a schedule in place for Eric's transplant. The countdown begins on Tuesday (Day -9) when he will start his conditioning chemo. Chemo continues through Day -2 and on Day 0 (Thursday Aug 7/08) he will receive his donor's marrow. Although he will be considered an inpatient, he will be allowed to remain at home with daily trips to the BMT clinic. When he gets to the point that he is too sick to want to get out of the hospital bed and go home, he will already have inpatient status so getting a bed will not be an issue. We like that approach, it gives him the best of both worlds. Outpatient transplants are not common but if the facilities can support the patient with that type of flexibility and a caregiver is available, most people do very well as a level of activity is maintained and the sheer boredom of a hospital room for several weeks is avoided.

We'll be updating the blog daily to keep you all up to date on how things go!

Blogging For Blood Cancer

Came across this nifty idea at this site .

The first annual “Blogging for Blood Cancer” event will take place from August 11-18, 2008. This first time event will bring bloggers from across the United States together to raise awareness for The Leukemia & Lymphoma Society and its mission to cure leukemia, lymphoma, Hodgkin's disease and myeloma, and improve the quality of life of patients and their families.

Wednesday, 9 July 2008


Haven't posted because everything is great. Eric is feeling super and thoroughly enjoying summer. I'll post pics another time.

For now though, a break from Hodgkins... This YouTube video has to be one of the cutest things I have ever seen. Someone in this house will need to learn a lullabye before we get the next puppy! I'll give you a clue -- it won't be me!