Well That Didn't Take Long

In my last post I said that we would see how the nodes did when the Medrol was reduced and the Rituxan wore off. Well the nodes are back. The big one under my right arm popped up Sunday morning.

We saw Dr. Tam in the leukemia department this morning. We had already plotted our plans B & C, so we explored those at more length this morning.

We are going to start on a drug by Sunesis Pharmaceuticals. It doesn't even have a name yet, just a number, SNS 032. I thought I would be in one of the phase I studies where they are just trying to determine what dosage might work - pretty experimental. But we found out this morning that they have now moved into Phase II studies. That is good news because it means that they know the effective dose. Phase II studies test the efficacy of the drug on a larger sample of guinea pigs, er, I mean people.

This drug is different than what I've had before. It blocks the pathway for the development of more disease and increases the death rate (called apoptosis) of the diseased cells. So it's not just more of the same old stuff that never worked for me anyway.

I have a successful transplant. But the problem is that the transformed disease is already in the lymph nodes. Given enough time the graft would probably act on the lymph nodes, but we may not have the luxury of that much time. Plus we have muzzled the graft cells after we induced GvHD. Now we are slowly taking the muzzle off again while trying to find the right level of Tacrolimus (anti rejection drug and muzzle) and taper off the Medrol. We want to be completely off the steroid Medrol and maintain the Tacro level right on the line between having GvHD and not having it. We're still a few weeks away from finding just that right place. Dr. Tam would like for us to tolerate some GvHD in order to get more GvL, but a rip roaring case of GvHD can be deadlier a lot quicker than the lymphoma.

So here we sit, betwixt and between. It will be three more weeks before we can start the Sunesis study. I'm really ready to get home. The transplant doctor has okayed me to go home at the end of next week but that all depends.