Dane,

Best wishes and keep fighting.  It sounds like you're on the right
track.  You've been an inspiration to us all.

Gay Bratton

-----Original Message-----
From: [email protected] [mailto:[EMAIL PROTECTED] On Behalf Of Dane
Sent: Tuesday, April 26, 2005 9:45 PM
To: [email protected]
Subject: [CML] Re: [CMLHope] 76 Days Post BMT----First Setback



Thanks Rob and all for the encouraging words. 
 
Tacrolimus is now being reduced to induce some GVHD so that it may 
in turn induce a little GVD.  We are also considering bringing 
Gleevec back into the mix...possibly on Monday.

My research onc is aware of the situation, and is currently checking 
for a BMS trail for post BMT molecular relapse.

I believe that with a little gene targeting therapy "boost" can kill 
off the stragglers and let my new immune system take over in full. 
Talpaz also sees great possibilities with this idea.

It is like the three pronged scenario I mentioned to you earlier.

Gene therapy to induce remission or near remission
"Gentle chemo with no radiation and transplant
Gene therapy on the back side to finish things off.

I've got it all in play with my oncs....so now all I can do is wait 
and try to keep busy.  They are still giving me permission to go 
home between cinic days...so I probably will be spending a lot of 
time commuting back and forth from home to Houston.  Beats sitting 
in a rented apartment wondering what the hell is going on inside me.

This is the most difficult undertaking I have ever experienced.









--- In [email protected], "Rob" <[EMAIL PROTECTED]> wrote:
> I hope you will be able to get the levels down further soon. The 
BMS or AMN drugs would probably be good options if that is needed.
> 
> Rob
> 
>   ----- Original Message ----- 
>   From: Dane 
>   To: [email protected] 
>   Cc: [EMAIL PROTECTED] 
>   Sent: Monday, April 25, 2005 4:24 PM
>   Subject: [CMLHope] 76 Days Post BMT----First Setback
> 
> 
>   Day 76 brings my first setback since the BMT process began.
> 
>   I received the results of my second biopsy today.  It showed 
that I am now 100% donor cells (good) but my BCR-ABL level is up to 
13.5 (not good).
> 
>   In comparison,  my first biopsy came back 99% donor cells and a 
BCR-ABL level of 1.0.
> 
>   Dr. DeLima explained to me that the anti-GVHD drug tacrolimus 
also reduces the donor cells' ability to fight the leukemia, so now 
my tacrolimus dose will be decreased.
>    
>   The plan is to induce a small amount of GVHD in order to achieve 
Graft Vs Leukemia. Graft Vs Leukemia can start to bring the BCR-ABL 
level back down.
> 
>   Dr. DeLima has also mentioned the possibility of bringing 
Gleevec back into the mix, but I have my doubts about this because I 
have already shown a resistance to the drug.  I talked with him as 
well as with my research onc about replacing the use of Gleevec with 
one of the newer BMS or AMN107 drugs to knock out the BCR-ABL and 
give my new immune system a helping hand.
> 
>   He thought enough of the idea to email my research onc to get 
his opinion.  I sent my research onc a similar email and expect to 
hear back from him soon.
> 
>   In the meantime, any chance of going home early is now gone, as 
my test results were not optimum.  I will be here for at least 
another month, possibly longer.  The good news is that as of this 
writing, I should still be allowed to go home on weekends.
> 
>   As of this writing, I am still only in clinic two days a week, 
and I am still off home infusions unless my magnesium levels drop 
lower than they are. 
> 
>   So I wait....three more weeks until another biopsy, one more 
week to get those results.
> 
>   Tick....tock.....tick....tock, etc.
> 
>   Not the best day I've had since this thing began.
> 
>   Dane






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