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Here it is, August 15. I'm in St. Joseph's Hospital in Atlanta getting the third course of chemo, a regimen called Hyper CVAD part B. I'll get four to six courses total of this regimen.

From my last posts you will notice that I mentioned the sudden swelling of lymph nodes in the left side of my neck in April. They did a biopsy on a node in my neck in May at M. D. Anderson along with a Petscan and CT scan and a bone marrow aspiration. These tests clearly showed that the leukemia had spun off another disease, diffuse large cell lymphoma - the dreaded Richter's Transformation. They put me in the hospital there and gave me the first round of Hyper CVAD part B. This has to be administered in the hospital because one of the chemicals, Methotrexate, can cause kidney damage, so they put you in the hospital to monitor the kidneys and give you antidotes to the kidney damage.

I received the second course in Atlanta in early July. Then I went back to Houston for restaging again. Restaging is testing involving a PETscan, CT scan, bone marrow aspiration, and blood work. The good news is that the swelling went down dramatically after the first course and came down even more after the second course. The scans showed remarkable progress against the new lymphoma growing in my neck - in fact it was gone. But probably only for now.

Since the formation of the lymphoma occurred after the transplant and the DLI's (donor lymphocyte infusions) the first transplant was declared a failure.

So the plan now is to try to kill off the lymphoma - no easy feat - and proceed to a second transplant. So far it is encouraging that the lymphoma has responded well to the treatment.

In the meantime I decided to seek another opinion. I went to Seattle to the Fred Hutchinson Cancer Center, "Hutch" for short. They actually did the first bone marrow transplant years ago at Hutch and it is considered one of the premier transplant programs in the country. I was very impressed with their degree of organization and the amount of time the doctor there spent with me during my consultation. It's very possible that I will have the second transplant done there.

My transplant doctor at MDA didn't begin lining up the second transplant as soon as I thought he should have so I changed transplant doctors at MDA. They are still working on insurance approval before they can line up the second donor. And this is happening as I'm getting the third course of treatment, so I'm not too happy with the progress. I had two perfect donors identified last summer, and they are banking on that second donor still being available and willing to donate. But they won't know that until we go through the insurance exercise and actually make contact with the donor.

So there we are, somewhat in limbo for the next few weeks. We have to see how the lymphoma responds, how many of these treatments I can stand, and how the donor search proceeds. Then add to the mix deciding whether to stick with MDA or go to Hutch. It promises to be interesting.

In the meantime, Tech looks like they have a very good chance of beating Notre Dame in South Bend on September 1. My prediction is that we will be able to overcome the refereeing and "Touchdown Jesus" to come out with a close win.