Day 1 in Houston

Good morning everyone.........coming up on 8 am in Houston, I'm in the comfy lobby lounge room at the Rotary House International, the hotel owned by MD Anderson and connected to the clinic by skybridges - it's very convenient for patients and their families - but let me get right to the medical stuff, and save my color commentary for those of you who are more avid readers.

If you read my Friday post you know that when I saw my local oncologist he measured my white cell count at 75,000, down from 86,000.....well the first thing that happened yesterday was that I had "labs" (blood counts) done and my white cell count was 94,500.  The nurses and docs here had little to say about all that, except that they had confidence in their numbers, not the local numbers - I suppose their certainty can be forgiven since they are the #1 cancer clinic in the US  :-).  I could write a sermon about that issue, but suffice it to say it was the only bad news we got yesterday.

Dr Keating was his usual jovial, upbeat, warm and fuzzy self - the key points he made were - 17p patients, of which I am one, come in two major groups - those with mutated chromosomes (let's call them mutants) :-) and those with unmutated ones.  He said that I am a mutant, and that's good (there is a t-shirt in there somewhere)  - mutants do much better with the FCR treatment than non-mutants.  The statistics are that out of all 17p patients, the treatment achieves complete remission (CR) in 35% - but the mutants achieve 70%, and the achieved remissions are longer and more stable.  A word about statistics - sometimes they are nice to know, and sometimes they are discouraging.  Sometimes my outcome on any variable is consistent with the weight of the probability, and sometimes my outcome is the unlikely one.  This is why "God is in control" is the most logical and comforting thought process in all these situations.  It is very unlikely that any person gets CLL, but I did.  It's very unlikely (less than 10% chance) that a CLL patient has the chromosome 17p abnormality - but here I am....so we had some good statistical news yesterday but God is and remains in control and my outcomes do not rest in and are not determined by statistics.  So Keating said this treatment is the right one, this is the right time, and my chances of getting into a long (2-5 years) remission are good.

Second, Dr Keating told us about a new class of drugs that are T-cell inhibotors of some sort that have been unexpectedly and extremely effective in treating relapsed 17p patients (patients who have been treated with chemo in the past).  They are even working well on patients who have relapsed after stem cell transplants.  They are crawling their way through the FDA approval process, but there may be trials in the next couple of years or even approvals that might figure into my treatment down the road.  So that's good.

Last bit of news is that I started my treatments in the afternoon and it all went very, very well.  I was treated only with Rituximab, which is a monoclonal antibody - in the first treatment, it is administered slowly through an IV because it tends to cause more reactions than the other two drugs in the protocol (I'm big fan of the TV series "24"  I just LOVE to use the word "protocol"  :-) - if reactions occur, they stop the drip until you stabilize and then start it again.  If the patient reacts it can take up to 10 hours to get it all into the body.  I sailed through, no reaction, done and dusted in 4 hours.  We were back in the hotel room in time to watch the 2nd half of the Auburn / Oregon game (congrats War Eagles fans - Frank, Tim!!).  So that is a big PRAISE.  

So that's the first day in a nutshell - not so good news on my white count (but no big deal), good news that I am a mutant, and excellent tolerance to Rituximab.  Renee is here with me of course and I am so lucky and so blessed to have her here.  All thanks and praise be to God our heavenly Father who works in all things for the good of those who love Him.

Today I start the other two drugs, Fludarabine and cyclophosphamide.  Should be a 2.5 hour process, starting at 7 pm....(great time for a dinner reservation but lousy time for Chemo treatments - nothing I can do about it).  As always, thanks for your prayers - please post questions and comments - love to all - Dan (The Mutant) and Renee (the Mutee).  :-)