Dear Barb,
Bisulfan is an alternative to total body irradiation. Our friend, Andrew, age 33, had a transplant at MDAnderson and they used Bisulfan. He is approximately 17 months post-transplant and is doing great. For Rob, the preference was total body irradiation according to Dr. Bashey. Dr. Bashey uses the Hutch protocol and the explanation was that with aggressive disease the TBI is used except in older patients or those with health problems who cannot withstand TBI. I spoke with Dr. Chamblis (I believe that is the name) the Director of the Transplant Dept at MDAnderson and he explained that MDAnderson does not use in TBI for ANYONE any longer and implied they think it is rather barbaric. Katrina Sharp's husband, Mark, is approx. 63 days post-transplant at the Hutch and they used Bisulfan on him. I think she told me that anyone over the age of 40 at the Hutch receives Bisulfan in lieu of TBI, but I can't find her email to confirm. Perhaps Dr. Bashey is using an outdated protocol from the Hutch. Jodi, Rob's Transplant Coordinator indicated TBI is preferable if the patient can withstand it but I am wondering if the current thinking is different. Katrina should have good info on the specific recommendations of the Hutch regarding Bisulfan versus TBI as I know she and Mark discussed it with the transplant doc. I am glad Dr. Druker gave you good input. We will all support you in your decision, whatever it is. P.S. Nancy is correct, a male donor is preferred over the female, especially a female with hx of pregnancy as the antibodies are increased and the risk of GVHD increased. Love, Kelly --- In [email protected], Neddo Family <[EMAIL PROTECTED]> wrote: > Nancy, > > Thanks for the great questions. We haven't called the transplant Dr. > yet. You gave us more things to consider. Tommy's donor is a 41 year old > male with one other potential donor. Dr. Druker did say that a younger > donor is better. Thanks for all your caring responses. I had been > looking for your email address to respond personally, but can't for the > life of me find out what I did with it. Guess it's that post 40 thing. > > Barb > > hey00nanc wrote: > > > > > --- In [email protected], Neddo Family <[EMAIL PROTECTED]> wrote: > > > > > Right now we are leaning towards transplant (given the higher > > success rates for SCT for pediatric patients provided by Dr. Druker). > > We have not made a final decision. We would like to call the > > transplant doctor and get more info. on survival rates and see if he > > absolutely has to use total body irradiation. > > > > __________________ > > Hi Barb, > > I am glad that your trip to OHSU was a good one and that you got to > > enjoy this beautiful city. > > > > A couple of things you might ask the transplant doctor (if you don't > > already have this info): > > > > 1) Tommy has a great unrelated match right now (12/12).....did he also > > have many other potential matches in the donor pool? (in case he did > > not have the BMT right now, would there likely be others if this donor > > were not still available). Do you know the sex and age of the donor? I > > believe that it is better to have a male donor (esp vs a female who > > has had pregnancies). Kelly might have more info on that. > > > > 2) Some places, like the Hutch, are definitely doing full BMTs without > > TBI. So, you might inquire about any different protocols that they > > have, and also any studies/trials about newer drugs for preventing > > GVH. > > > > 3) and ask about their specific stats for someone in Tommy's age, with > > CML, etc......and how do these compare with other transplant centers. > > > > I think that the bottom line is that you have to be comfortable with > > your choice of treatment and with those who will be treating you. Best > > of luck to Tommy....and your family. > > > > Nancy C. > > > > > > > > > > > > > > New! Sign up for local CML support group meetings in your local > > community at http://cml.meetup.com > > > > Apply for Commercial Real Estate loans online and submit your deal to > > dozens of hungry lenders in just minutes. Loan programs for all types > > of business and commercial real estate. 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