MDS: Good Bone Marrow Results

The early results are back from the bone marrow biopsy, and the news is good.

This while Shots Week continues with extreme fatigue, faint nausea, sore and itchy arms at the shot sites, and bowels that are uninterested in functioning.

Anyway, enough with the kvetching. The FISH test results show:

• less than 1% blasts
• no involvement of the chromosome #5q

Some brief explanation.

• The FISH (Fluorescence In Situ Hybridization) test "maps" the genetic material in a person's cells. This test can be used to visualize specific genes or portions of genes. More explanation can be found here.

• Blasts are "bad" or "dead" cells that are produced by the marrow. To have 1% or less is optimum/normal; the diagnosis is worse if the blasts exceed 5%. All people—even healthy ones like you—have some blasts.

• Involvement of the 5q chromosome is an indicator that the MDS is developing into more serious leukemia-like stuff.

So, these results are good—especially the blasts count, since it's the marrow producing too many blasts that creates the problem. The Vidaza seems to have the situation under control at this point.

Of course, no one knows how long the Vidaza will work . . . but, that's a whole 'nother story.

We still await the standard cytogenetic report, which last time took two weeks to come back. If I understand things (not a sure bet), it will show what changes (hopefully none) have occurred in all the chromosomes. Assuming no alarming results are reported from that, it appears I'm holding my own.

Good news, yes.

Considering, however, that this news comes in the middle of a Shots Week that has me feeling like I've been run over by a truck after having been summarily head-butted and kicked in the stomach and groin, I'd say it's like receiving $1 million dollars from John Beresford Tipton (remember The Millionaire?) while watching your house float away during a flood.

It's hard to celebrate when you're feeling like crap, so I'm saving much cheerful cheeriness for next week.

MDS: Drilling for Bone Marrow

Yesterday we endured the landmark bone marrow biopsy ritual.

Landmark because it comes after the fourth cycle of Vidaza shots, the time when true signs of Vidaza success should show up. Ritual because this is bone biopsy Number Three in what we hope won't be a long line of such tests.

Dr. O now takes the sample from the back of my pelvis. It begins with a couple of royally large novocaine injections. Not a mind-numbing experience. Rather, an upper butt-numbing one.

The procedure itself feels rather like someone is thumping on you with a hammer and a small, dull chisel or nail-set. Since I can't see what she's doing back there, I envision this small device delving into my bone and pulling out marrow as one might take a tree-ring boring or polar ice sample.

Mostly, I don't like to visualize that.

So, why are we doing this?

To see what the marrow is doing, as Dr. O puts it. Apparently we're looking out for

• increased blasts (bad, non-developing red blood cells)
• other abnormalities in the marrow
• and, much to my surprise, cytogenetics—further degeneration, stasis, or even minor miraculous repair (not likely), of the chromosomes.

From these results, we'll decide if the Vidaza treatments continue. (Which they will anyway, beginning next week, whilst we await the results, which Dr. O says should take a week, although last time the cytogenetics took two weeks, so I'm not sure what we'll know in a week.)

Apparently it was Dr. MDS who recommended this biopsy. Dr. O inferred that Dr. MDS wants it as a measure to use in considering the bone marrow transplant "because you're young."

For reiteration and clarification—age-wise, I'm right in the middle statistically for bone marrow transplant success, and still young enough to have decent chance of success.

Heck, I'm just happy to hear someone refer to me as young.

Meanwhile, yesterday's blood counts were good

• Platelets—139,000
• Hemoglobin:—12.0

indicating, as they have been all along, positive things.

So, next week, having graduated from being a core-sample guinea pig, I get to return to being a pin cushion.

Carry on, doc. Fill me with needles.

MDS: Vidaza and Reduced Blood Count Blasts

This week's good blood count got me to thinking (always a dangerous thing). A pattern does seem to be emerging: counts go down during Vidaza treatments, elevate a week and two weeks later.

We won't have counts for next week. We're getting the hell outta town and having a Maine vacation.

But, the new numbers and increased energy started me, with my usual trepidation, doing some Internet searching, where I discovered a recent press release.

It says that "VIDAZA significantly extends overall survival and helps patients with myelodysplastic syndromes (MDS) become or remain red blood cell transfusion independent. Patients who benefitted included those with higher-risk MDS or acute myeloid leukemia (AML) with 20-30% blasts, as defined by the World Health Organization (WHO)."

Now, I'm neither suffering from AML nor are my blasts at 20-30%— they're less than 5%.

(Blasts, by the way, are young blood cells that mature into red blood cells, white blood cells, or platelets. Excess blasts means an increased number of immature blood cells in the bone marrow.)

Okay, we already knew most of what the press release states because it confirms an earlier study. And, as has always been the case, the studies involved patients with worse situations than mine.

But, the idea that Vidaza might reduce blasts is encouraging.

The Vidaza Web site says of earlier studies that the major percentage of patients who responded when treated with VIDAZA achieved either a

• Partial Response (PR): No blast cells in the bloodstream. The number of blasts in the bone marrow has been reduced by at least half. Blood counts (red blood cells, white blood cells, and platelets) are at least halfway between where they started (baseline) and normal. To be considered a PR, blood count improvements must be maintained for at least 4 weeks.

Or a

• Complete response (CR): No blast cells in the bloodstream. The number of blast cells in the bone marrow is at or near normal. Blood counts (red blood cells, white blood cells, and platelets) are also at or near normal. To be considered a CR, blood counts must remain at or near normal levels for at least 4 weeks.

I'm scheduled for another bone marrow biopsy towards the end of August. The blast count will be of particular interest.

Meanwhile, the study cited in the news release carried on for about two years. I'm more than happy to continue doing what I'm doing for the next two years if that's what it'll take to see reduced blasts and increased platelets.

Who knows? Maybe my golf game will improve by then. Or, perhaps more likely (although not very probable) maybe the Mets and football Giants can win championships by then.

Do you believe in miracles?