I was waiting in the ATC hallway this morning when Jerry Mayfield
came up and introduced himself to me. What a pleasure it was to meet
the great CML warrior. It was at his website where I first learned
about the existence of STI571 when I was still walking around in an
Interferon fog. It could be said that Jerry is one of the people
who saved my life.
We discussed his case and how he was doing on the BMS drug. I'm
glad to say that he is still doing great and remains in CCR.
Considering the rough road this man has been down, he deserves it.
I believe he is still with us because of his unwillingness to give
up.
We discussed my tranpslant recovery for a while and about the "old"
pre-Gleevec days, and then he told me some very interesting news.
Jerry has a friend (and has news of others) who have had transplants
(related or unrelated donor I do not know). These patients had been
several months out of transplant when tests came up with minute
traces of the disease.
He said that Talpaz put them on the BMS drug and shortly after that,
both patients had ****no morphological evidence of the disease****.
Jerry mentioned that Talpaz was excited about the drug's potential
in catching lingering mutations in post transplant patients and
thinks that for some patients, this could be the coveted "one-two
punch" treatment. I will be sure to discuss this scenario with my
transplant onc the next time I see him.
We then discussed the stigmata associated with the dreaded Bone
Marrow Transplant. Jerry reminded me of the great strides have been
made in BMT science in the past few years and that the BMT may still
play a crucial role alongside gene targeting therapy, rather than
becoming obsolete because of the same.
I can use myself as a good example:
Diagnosed in early 2000, Gleevec was around but still in clinical
trials. I started the current first line treatment of INF/ARA-C
therapy which began to ravage my body. I also started trying to get
into STI trials but was rejected twice. By November, I was
approaching blast phase and very very sick. My onc sent me to
Houston for a transplant.
While there I pressed my team for admittance to an STI trial,
knowing I was extremely weak and might not stand the rigors of the
BMT. (Important to know that back then, I would have had radiation
treatments as well as chemo!). The doctors heard me and found a way
to get me into an STI (Gleevec) trial, and I flew home the next day
with a bottle of pills. I do not believe that I would have survived
a BMT in 2000.
1.5 years later, I was in CCR and feeling great. Thank God for
Gleevec. Life went on nicely for another 3 years and then a routine
test showed I was becoming Gleevec resistant, and I ran back down to
MDACC as fast as I could.
For reasons well discussed previously, my team decided a transplant
this time around was the best course of action. I went through it
(no radiation due to new chemo protocols!) and as of this writing,
40 days out, I feel better than I did while in remission on Gleevec,
and waiting for the results of my first post transplant biopsy.
The difference is, this time I went into the BMT while still
relatively strong due to my 4 years of Gleevec therapy. I was still
in hematological remission and only 20% PH positive versus 100% PH
positive and getting ready to blast. I went in this time weighing
230lbs....when I last faced a transplant I was an emaciated 144lbs.
So it was Gleevec that first brought me back to remission from near
blast phase and kept me there for several happy years. When I
relapsed, I had the luxury of being in excellent health and physical
condition to withstand a BMT, which seems to be grafting nicely.
Now, if the BMT does not clean me out all the way, there are several
new drugs on the horizon that have already shown promise
in "finishing" the job in the post BMT phase. I may be able to
utilize these new drugs as well, if needed. There is a very good
chance that they may be not needed at all.
Perhaps such a three-pronged treatment plan would be a viable option
for some patients in the future. Ah...but I digress.
It was wonderful finally meeting Jerry today, and I was overjoyed to
find him looking so happy and healthy!
Here's a snapshot from today.
http://www.fototime.com/B3EA513E1A86A20/orig.jpg
Regards and prayers
dt
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