Started Chemo & Tech Needs A Coach

I started chemo with Rituxan, actually a monoclonal antibody, last night. This morning I got Carmustine, which is part of the BEAM regimen. It is a drug that kills this kind of cancer cell. The Carmustine wasn't too bad. It gave me a little headache at the temples and made the back of my nose inside burn like when you walk outside on a 25 degree day. But neither side effect lasted long.

Tomorrow I get Etoposide and the dreaded Cytarabine. I've had Cytarabine before. That will start the slide of all the blood counts. Since the goal of BEAM is to wipe out the bone marrow, I know my counts will necessarily go way down. So blood and platelets will be in my immediate future.

They are going to replace Campath with Thymoglobulin because Campath can cause mixed chimerism. Chimerism is the mix of donor cells and original cells. They measure chimerism for the myeloid (red) cells and the T cells (white cells). Last time I got 100% donor myeloid cells but the donor T cells failed to take over. I still have 100% of my first donor's blood type, A+, but very little of his white cells. So I have what is called mixed chimerism. Campath is a drug that is effective against CLL, my original disease, but it can contribute to mixed chimerism. It is also effective against GvHD. So it has some positives, but the top priority is to get the T cells of the donor to take over and kill my disease. Thymoglobulin is a substitute for Campath in the fight against GvHD.

The transplant is still on for next Thursday, the 8th, as far as we know. Today is Day Minus 6.

After Day Zero we will be hoping and praying for 100% donor T cells at day 30. Actually at the 30 day mark anything above 95% is good. It will eventually build to 100%. Last year my T cell chimerism was only 67% at day 30 and 12% at day 60. This year they are completely wiping out my bone marrow, unlike last year. So with a complete ablation like this, how can the donor cells not make it to 100%? It seems that the only two options would be 0% and 100%. 0% would be a complete failure which they would follow up immediately with a second, emergency, infusion of donor stem cells. If it's possible to fall between 0% and 100% they might get some mature lymphocytes (mature white cells instead of stem cells) immediately from the donor and supplement the transplant with those. We actually tried four DLI's (donor lymphocyte infusions) from the first donor, but they didn't help fast enough, getting the chimerism up to only 37%, and then the disease roared back in April and overwhelmed the transplant.

I missed my prediction of the results of the football game last night badly. VT came out with an on side kick early, thereby claiming the element of surprise which Georgia Tech so badly need. We seemed to be playing on the back of our heels the rest of the night. We just got out coached again. It's time for a new coach. I don't mind losing games, having been a Tech fan for so long, but at least we should play like we have a plan to try to win the game.

I vote for Bobby Johnson at Vandy to replace Gailey. I think the writing is on the wall for Gailey. Apparently the fans booed him roundly most of the night. I hate to see that since, after all, it is just college football. The booing is bound to affect the morale of the players. But when college coaches make well over $1 million a year and more than the presidents of the schools, they have to expect to take some heat from the fans who are paying those big salaries. Time for a change. I'm not impressed with Tenuta on the defense either. He has only one approach, blitz. That's okay when it works, but when it doesn't work, you have to alter your game plan - not something Tech does well under Gailey. We're a one dimensional, predictable team. When you have limitations like Tech has always had, you have to be a little more creative. How about a little wish bone or a shovel pass now and again?

'Nuff said. Thanks for reading.