Following the negative match with my brother last month, my case
was referred to the Hammersmith hospital in London, under the team
of Professor John Goldman. He is one of the world's leading scientists
in the search for better treatment for laukaemias. At least I know
I shall be in the capable hands of a competent team that has many
years experience in dealing with my condition.
The purpose of this visit was to determine the next course of
action. Prof. Goldman (an eccentric, character who seems to be constantly
in depth thought) did approached my case head-on, starting with
the risks involved. He outlined the different treatments available
as well as their respective risks.
- Interferon. This is a protein
that the body naturally produces which is used in helping to fight
infections. The drug is artificially produced to be stronger than
the body's version, and is administered as a subcutaneous injection
several times per week. This line of treatment however doesn't
represent a long term cure, as it only serves to prolong the patients
life. In some cases (about 20%) there is a long term remission
where there are no signs of leukaemic cells. From what I have
been told, the median life expectancy with Interferon is about
6 years.
- Signal Transductor Inhibitor - STI
- (Sounds like a radar jamming device off Star Trek). Infact it
works in the same way, by blocking the mutated gene involved (Philadelphia
Chromosome) from producing abnormal amounts of the protein that
controls the white blood cell production. The treatment is in
its infancy, and at the moment is currently available on a trial
basis. Although the results from this treatment appear to be positive,
there is little over a year's (at the time of writing) worth of
results. This means there is no way yet of knowing the long term
consequences of the treatment, and therefore now way of knowing
the potential of a long term cure.
- Bone Marrow Transplant - BMT -This is currently the only
successful long term option available, but it is a risky alternative.
For this reason, the BMT is only offered as an option to younger
people (under 50 years) due to the aggressive treatment which
involves very high does of radiation. Professor Goldman told us
to expect a 30-35% risk of mortality in someone my age undergoing
BMT; however, he suggested if successful, this would potentially
offer a cure.
Whilst the risks may indeed sound high, I prefer to look at it
as a 65-70% chance of living, and if anyone were to offer me those
odds over dying in 6 years time, I would not hesitate in choosing
the BMT. The main window of risk with the BMT is in the first 6
months post BMT. Contrary to logical assumptions the actual transplant
itself doesn't pose the biggest threat. It is the body's own bacteria
that are life threatening.
In normal circumstances, the body plays host to a variety of
bacteria that it manages to keep control of. After a BMT operation
however, the body's new blood doesn't know which of the current
bacteria should be kept under control, as it is used to a different
set of bacteria that the donor's body has. It takes the bacteria
a few months to realise that the new blood doesn't know about it
and at this stage the bacteria begin to proliferate. This when the
patient is at the highest risk, but detailed blood analysis prior
to, and subsequent to the operation can assist the doctors in administering
the correct drugs to combat this problem. Once the initial 6 months
passes, the new blood finally manages to do bacteria audit
and learns about the body's bacteria that need restraining.
We also learned some good news, after a brief check of the database.
The search revealed 2 potential donor matches, one in the USA and
the second in Germany. Although they may be matches, more detailed
blood tests need to be carried out to determine the degree of compatibility,
in order to reduce as much as possible the effects of graft vs.
host disease. This takes some time, so we were asked to make an
appointment for 4 weeks time, at which point, hopefully, we should
find out more information about the potential matches
