The Plan is...

I very nearly missed the doctor's meeting with Kristi. I was out doing my "chores". So yesterday, the plan was to start chemo today. However, she has the opportunity to join a study which involves the introduction of a new drug. This decision will delay the start of treatment till tomorrow. The standard regimen involves two drugs over the course of 10 days. A so-called 7-3 schedule. Seven days of one drug continuously, and three days of another. The experimental drug, Mylotarg, is actually available as a "salvage" treatment, when other courses of action have failed. This study will introduce it on the 4^th day. The consequence of taking the study route isn't yet clear. It basically requires the other two drugs to be attenuated to allow the Mylotarg in. So all three drugs receive less than the standard dosage. The doctor doesn't believe this will be a disadvantage. However the major issue happens if she needs a marrow transplant. There can be issues involving the liver in this case. So we hope that deeper analysis of the marrow will tell us if this is necessary up front. There as been a refinement of the diagnosis too: Acute Undifferentiated Leukemia with a tendency for the Myeloid variety. This is due to the fact that the abnormal cells are immature and haven't strongly expressed a particular preference. However about one in 300 are of the Myeloid variety. The current plan is to start tomorrow, with Kristi making her decision tonight.

The course of the next few weeks will involve Kristi's immune and blood production systems being destroyed, "wiped out" as the doctor puts it. She probably won't experience nausea, they have excellent drugs for that now. But, she will loose her hair and be restricted to the 4^th floor.