Bart's Again x4

After 11 days back at home, we returned to Barts Hospital for a 9am appointment at the clinic with Professor Gribben as they wanted to talk about a bone marrow transplant (BMT).
By 10.15am we were still waiting for Professor Gribben to turn up (no one knew of his whereabouts) so we saw another consultant, Dr Heather Oakervee, instead. Sarah had received a call whilst at home requesting that she come to the Haematology clinic to discuss a possible BMT with the consultants which concerned Sarah as she was told 6 weeks ago that her treatment would consist of only Chemotherapy with no BMT. So, she had spent the last few days at home worrying why all of a sudden they were talking possible BMT. However, Dr Oakervee explained to us that from the beginning they look for BMT donors for all patients in case it is needed further on during treatment. The worldwide search had returned one possible donor for Sarah, a 9 out of 10 match (nothing to do with Whiskas I presume); ideally they would use only 10/10 matches and only 9/10 matches if the disease was still resistant to Chemotherapy and a transplant was the only viable treatment to secure remission for the patient. As all transplants have advantages and disadvantages – especially GvHD (Graft versus Host Disease) where the donors bone marrow attack the body of the transplant patient (the host) and can lead to fatality. It is important to remember that the consultants can not cure you from leukaemia but they can seek long term remission from the disease, with are all mortal!
Sarah's presentation of AML was classed as inversion 16 (a good risk AML) but she also had chloroma (lumps) present around her body which made the method for treatment not a classic textbook case. It is uncommon for inversion 16 AML to be presented alongside choromas, which are normally present with high levels of leukaemia in the bone marrow (over 20%, whereas Sarah had 13% Leukaemia in her bone marrow back in April). Sarah’s bone marrow is now in remission and the consultants do not advise that a 9/10 match BMT would be more beneficial for long term remission over chemotherapy, so we are going to continue with a fourth, and last, cycle of Chemotherapy; even if a 10/10 match was found the consultants advised that the decision for and against a transplant would be an incredible difficult one to make, as inversion 16 is treatable with long term remission via Chemotherapy, but the chloroma’s present added a different spin on the text book treatment.
So, Sarah will begin her 6 day high dose Chemotherapy as in cycle 3 so by Tuesday 12pm she would have finished her course, and then wait for the bloods to come down and then come back again until she will be finally sent home……..for good J. It is a strange feeling as we start cycle 4 knowing that this will be (hopefully) the last time Sarah’s body will go through this treatment and she can come home. We were in such a rush to get to the last cycle of treatment that now we are finally here, there is no rush to hurry through this course we need to make sure that the treatment works, Sarah remains healthy and she can secure a long term remission. AML will never go away, and shall always be in our lives but it is an acceptance that you have to carry on and not let it influence you too much, one thing is certain we can not and will not go back to the lives that we had before all of this.
As Andy Dufresne said in the film The Shawshank Redemption:
“I guess it comes down to a simple choice, really. Get busy living or get busy dying.”