I have talked with Karma a couple of times this last week about what is happening with Detlef currently. Recently Detlef had a bone marrow biopsy to see how much of a remission the first round of chemo has accomplished. So far the numbers are looking promising for them to move ahead with the bone marrow transplant. Detlef will be going in for more testing this week, on his heart and other organs to make sure they are all stable and healthy enough to undergo the process required for the transplant. Basically, Detlef would have a procedure called TBI (Total Body Irradiation), to kill all of the bone marrow throughout his body. This is required to stop his body from making the cancer cells being produced for his bone marrow. For the transplant to be successful, his bone marrow needs to be completely irradiated, so that the bone marrow cells from Dietmar would be able to take over and start making healthy cells. Your bone marrow makes red blood cells, white blood cells, and platelets. All of these cells accomplished different things like carry oxygen and nutrition around to our cells, help kill off foreign bacteria and viruses that invade our body, and also allow our blood to clot. When the bone marrow transplant is completed, hopefully the healthy cells that Detlef receives from Dietmar will take over this process, after Detlef's own bone marrow is killed off.
Detlef has met with the transplant doctor in Denver, and the goal is to get the transplant done as soon as possible. If Detlef were a child, they would probably wait a longer time, because remission can last a long time, but with adults the risk is higher. If they choose to wait, then the cancer cells could come back, and could spread to other parts of his body before they could do anything about it. It is definitely weighing one risk against another. Both options are risky, and could have bad outcomes. To completely irradiate your bone marrow is risky because you could get an overwhelming infection prior to the bone marrow transplant being completed. Waiting is risky because the cancer could return and be in many more places and harder to treat. Both options aren't great, but to survive this type of cancer requires you to make hard decisions, and weigh the pros and cons.
Currently Detlef is looking at going to Nebraska to meet with a doctor there to get a second opinion about the timing of the transplant. He has contacted them and is waiting to hear back. He will either fly there for the consultation, or he and Karma will drive there. This is a big decision, and Detlef wants to make sure that he knows all of his options. In the meantime, they are waiting to hear back on more results from the bone marrow biopsy as well as the testing he will have on all of the major organs of his body. Another reason they want to move ahead with the bone marrow transplant as soon as possible is that the more chemotherapy Detlef receives, the potential for weakening his body increases. They want to do the TBI while his body is relatively healthy. Thank heavens Detlef has been eating healthy, riding his bike to work, and running with Chance at the dog park. He started this whole process with his body very healthy. This is definitely to his advantage when faced with treatments that cause damage to your body.
Please continue to keep Detlef, Karma, Juergen, Dietmar and Jennifer in your thoughts and prayers. They have so appreciated all of the kindness and love shown to them by many friends, family, and co-workers. Detlef has really had many miracles happen so far in his fight against ALL, and wants everyone to know that he has felt their support.
Stay tuned for more information as we receive it over the next little while. If everything goes well, the transplant could be happening in the next couple of weeks.
Love to all,
Lisa
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