Today's Visit

Quite a day - NO Neupogen shot! Yea!
WBC = 6.59 - normal range :)
RBC = 3.72(L)
Platelets = 58(L)
Neutrophils = 3.09 - normal range, no shot needed.

In addition to our lab and clinic today we had a conference with Dr. Kiem.

We are ever grateful for their knowledge, and yet, as much as they know, there is still much they don't know. (They aren't afraid to tell us that either.) Here are some notes from that conference.

- Bone Marrow results show persistent CLL,
and an unusual finding: good donor T cells present, but has lost the donor Myeloid cells. Don't know why there are no detectable donor granulocytes. Hope the DLI (donor lymphocyte infusion) will help to bring them back if they are present in small numbers.

- Viral studies (for hepatitis, etc.) were negative (sometimes viruses can lower blood counts, but that is not the reason here).
- Chromosome studies were abnormal with CLL (we knew about the CLL but 2 new abnormalities were possibly found. They may contribute to the low ANC (absolute neutrophil count, which is the neutrophil counts we've been showing each time we share the counts). We will follow those and see if they affect the myeloid line of cells. It is concerning, but not yet technically a disease.
- kidney and liver functions are fine (some high numbers, but not critical and not significant).

He may receive more than one DLI, will wait up to 4 months to see response to this one. They will be storing lymphocytes from donor for another DLI if needed.
If the DLI does not work we may need another transplant of donor stem cells. (They told us to be good to our donor) We are eternally grateful for our donor!!!!! We don't think we could ever re-pay him for his good works on our behalf, but we love him and his family. We love all of our family and thank each one for their love and their kindness.

We reviewed the Pulmonary Function Tests (which were good) and the CT Scan (also good, but they did notice that Terry might have a bit of pneumonia, which does not pose a problem, he is taking a medication that will help that), and the skin biopsy was negative for GVHD.

We have been instructed to watch for symptoms of GVHD again and reviewed what those symptoms might be.

The goal is to get rid of the leukemia cells, without causing too much harm from GVHD or aplasia (loss of blood counts, bone marrow production).

We will see our doctor (at home) on Monday, check blood counts weekly and chimerisms monthly.

DLI is scheduled for 3:00 tomorrow.
We plan to come home Friday.

We are back at the SCCA House and Terry is resting. We had a short but sweet visit from Bishop and Carly and they brought us a fantastic lunch (thank you!).

It's a little too cold to be spending our time in the outdoors today, but we will probably visit with Dennis and MaryAnn, as they are checking in this afternoon.