It’s about 6:00 now; I’m going to head back to the hospital to spend the night with Beth (I went in to work four hours today, and got a few things done).
Beth is going to get her first dose (of three) of Thymoglobulin, which, I understand, suppresses the immune system. She’ll also get the last doses of Fludabarbine and Busulfan. They’ve given her some “pre-medications”, which had her sleeping all day. We’ll see how she handles all this tonight.
For the next two days, then (the 13th and 14th), she’ll get the Thymoglobulin and the total body radiation, and the donor’s stem cells should arrive here the evening of the 14th. By that time, our hope and expectation is that the leukemia-producing bone marrow will be completely destroyed.
Of course, then we have about a year dealing with issues such as engraftment, infections, and graft-vs-host symptoms, but the end of the leukemia is near.
This morning it came out “flubardine” and also “fludarabine”. But really, it’s this:
Fludabarbine: “It has been unofficially and casually referred to as “AIDS in a bottle” amongst healthcare professionals due to its significant immunosuppresive activity”.
She gets two more days of this, and two more days of the Busulfan. Tomorrow, with her last dose of those, she will get two doses of Thymoglobulin, which is another immunosuppressive drug. Then on the 13th and 14th she will get two day’s-worth of Total Body Irradiation.
The photo here shows Beth getting herself measured in Radiology. Including consultations with a doctor, a nurse, and a radiation therapist, we spent about two hours or more down there.
Beth will get two days of “total body irradiation” the last two days before the transplant. Dr Rossetti had told us that the radiation reduces the chances of a relapse by some 20% or more. Right now, I view the relapse as my biggest fear.
You can’t see it from the photo, but she’ll stand at this board that she’s on; she’ll be strapped in, and they’ll bring the big “Radiation-generator” thing right up in front of her. These measurements will allow them to adjust the amounts of radiation at parts of her that are thicker or thinner.
She’ll have two 20-minute treatments – 10 minutes on one side, then they’ll flip her over and irradiate her 10 minutes on the other side.
The clear benefit of the procedure is to finish off any of the damaged bone marrow that’s left in her body, after the chemotherapy has had a chance to do its thing.
Aside from that, we went through the admission questionnaire – it’s pretty thorough, and for the first time, today, I saw a lot of these “history” questions being entered into a computer. Most of the time, they get hand-written on a piece of paper and stored away in a chart. She also got a treatment today called the “IVIG” treatment – it’s not a chemotherapy, but it’s supposed to enhance her ability to fight off viral infections, even as the Fludabarbine suppresses most of the rest of her immune system. She’ll get her first course of that tonight; she’ll have five days of the Fludabarbine and then four days of Busulfan.