Day 100

Today's the big day - Day 100. Actually it's not so big after all since the transplant process is not over. Several other BMT patients told me that 100 is just a number. One of the guys that told me that was there about 10 months. But, even if I'm not through with the process, at least I'm at home and not still living in the hotel in Houston.

Because of the resilience of my old cells, Dr. Khouri has me on a Donor Lymphocyte Infusion (DLI) protocol. That is where they give me infusions of mature lymphocytes, white blood cells, to supplement those generated by the donor's stem cells. The idea is to over run my old cells and finish killing them off. There will probably be three or four infusions of donor lymphocytes.

The first DLI went smoothly two weeks ago. Since then I received a Rituxan infusion last Monday. And, I'll get one more tomorrow. The Rituxan infusions are part of the DLI protocol, which calls for Rituxan twice before the first DLI and twice after. The second and third DLI's don't require Rituxan infusions. So I'll be done with that after tomorrow - at least for awhile. Rituxan, in addition to attacking the CLL diseased cells, leaves a receptor for the new lymphocytes to attach to, hence, making the lymphocytes more effective.

In the first lymphocyte infusion you get a million cells. In the second and third infusions you get 10 million and 100 million cells, respectively. Yep, you read those numbers right. Seems like a whole lot of cells, but I guess these are real little cells. They build up the number of cells over the three infusions in order to lessen the chances of severe GvHD. These lymphocytes are foreign mercenaries looking for something to kill. The idea is to kill my diseased cells, but not the rest of me, so I appreciate the somewhat gradual buildup in the cell numbers of the infusions.

I'll get the second DLI the second week of January. I'll also go through a PETscan, a CT scan, a bone marrow aspiration/biopsy, and blood tests. They use that series of scans and tests to "restage" the disease, basically to see how it stands at this point. They will repeat those scans and tests before the third DLI and then about a month after the third DLI. Each time they will decide if I need another DLI based upon the results of the scans and tests.

I didn't have even a hint of GvHD with the first DLI, but the chances increase with each DLI due to the increase in the number of lymphocytes infused. Most instances of GvHD are just rash or sores in the mouth. The more severe reactions affect the liver and the GI tract. The better the DNA match between the donor and the patient, the less likely a severe case of GvHD will occur. Fortunately, I had a perfect 10 out of 10 match with my donor. But I'm still a little nervous about a GvHD reaction, although a minor reaction would actually be a positive sign that the transplant is finally getting rid of my old leukemic cells. But you have to be careful what you wish for.

Football wise, all I can say is at least Tech will have a new QB next year. We lost the last two games after controlling the game through three quarters but were unable to score but a few points. Then we gave up a late drive to the other team for the winning score. Sadly, Tech was two touchdowns better than both Georgia and Wake Forest, and lost both games. When your senior, four year starter, quarterback completes only 15 out of 51 passes and gives up four interceptions, you're just not likely to win. It didn't help that the head coach refused to substitute with the very capable backup quarterback that we have. Needless to say, fans were not too happy with the coach nor the QB - in fact they pretty much blistered both of them in the sports blogs. Tech doesn't get many opportunities to win the ACC. So when Miami, Virginia Tech, FSU, and Virginia are all having an off year, you have to capitalize on the opportunity. Our coach flunked that course. The Gator Bowl may be another disappointing affair. But there are plenty of very entertaining games coming up in the bowl season.

More news later, probably after the next DLI in January.

So Merry Christmas and/or Happy Hanukkah and Happy New Year!!