February 27, 2011


I'm not sure how my mom is doing it.  A week ago last Friday, she had her husband going in for kyphoplasty (they inject a cement into the crushed vertebrae to reinforce the bone) while her son was going in for a bone marrow biopsy to determine why he's so anemic.  Options ranged from tumors crowding out the bone marrow to a preleukemia to some other more complicated possibilities.  In a nutshell, he was getting the exact same work up my dad got a few weeks back for his CLL.  Not being able to be in two places at once, I'm sure she was torn.  Unfortunately, there will probably be more circumstances like that.

My dad is recovering slowly.  Still in pain but he's recovering some movement.  In a week and a half, he's back down at MDACC to determine the next course of action which will most likely be chemotherapy.  [Caveat - Everything after this sentence is pure conjecture on my part from reading the literature and between the lines of his results.]  He's also going to be evaluated for stem cell therapy but I'm not real sure where that conversation is headed.  The fact that it is being offered cuts a bit both ways for me.  On the one hand, it's a curative approach which is definitely worth looking at.  On the other hand, I do not think they would be offering this unless his disease was serious.  Obviously, every cancer is serious but CLL is pretty wide ranging in its malignancy potential.  Stem cell transplants are not trivial and not without a risk of their own.  While his blood counts didn't look terribly severe, after combing the literature more, the results of his biopsy seem to indicate to me that he is in a high-risk category. 

Meanwhile, my brother's biopsy came back showing that two things are preventing his red blood cells and platelets from being produced.  The presence of tumor cells are crowding the regular bone marrow out, but there is also scar tissue present which further limits the bone marrow.  In the immediate term, he received 2 units of blood to buffer his anemia.  Not much can be done for the low platelet count.  So long as he doesn't encounter a serious bleed, that should be ok.  Long term, I do not know what the next step is for him.  My hunch is he will be headed for chemo, as well.  Whether or not any clinical trials are still on the table is unknown but we should have a better answer this coming week.

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