Next Steps...

Well, Jackie and I met with my transplant Doctor on Friday (Dr. Holmberg) and she laid out a roadmap (rough) for the upcoming weeks. I have to say, she seems to be a great doctor, probably the best I've had so far so that's good!

I have a myriad of tests the next couple of weeks some of which I've already completed like EKG, dental, physical, etc... This Wednesday is a big one and that is my restaging PET scan. This is going to determine whether I enter into the SWOG study for a tandem Auto Transplant. She said that if my disease has shrunk >50% then we can proceed with the tandem (pending insurance approval). If I still have more than 50% of disease prior to me starting GVD chemo, were just going to do the one transplant. She's worried that if I still have greater than 50% residual disease there's a chance my cancer could grow through the first transplant as it's a reduced intensity transplant with one conditioning regimen. In other words, if the cancer grows throught the first transplant, they have to pull me from the second transplant. This wouldn't be good because the second transplant is the one that really packs a punch and offers the chance of a cure. So to sum up, a perfect scenario would see me in remission after the PET (or >50% reduction), a tandem transplant would be scheduled where they would first give me single dose Melphalan chemo and then 1/3 of my stem cells back. I would then recover for 4-8 weeks then get my second transplant which would consist of conditioning chemo Cytoxan and VP-16 with 5 days of total body irradiation 2x per day. I would then get the rest of my stem cells back and recover for 6-10 weeks.

After the PET scan on Wednesday, I have a bone marrow biopsy scheduled for Friday morning. For this procedure, they take a 6" needle and penetrate both of my hips extracting bone marrow to be analyzed to see if the cancer has spread to my marrow (not fun). This will be the third time I've had to get one of these! So far, the first two times the test has been negative thank God.

So, I'm hoping for a good week of tests and looking to start some type of SCT first of November. I feel like I'm getting ready to deploy to Iraq or Afghanistan, pretty crazy...

With all of this said, I feel fairly relaxed and think I'm ready. The good thing is that no matter what, after all of this, I'm done with chemo! Like I said before, I have a good feeling things are going to work out :) In a way, they already have...