Thursday, September 30, 2010

Vidaza, It Is

After considering recommendations and options, Dori has decided to begin a regimen of Vidaza, a drug that has kept leukemia effectively at bay in many AML (acute myeloid leukemia) patients.

I fully support her decision, which is based on a recommendation from the Fred Hutchinson Cancer Center in Seattle. Vanderbilt’s team presented Dori’s case to the Hutch, and they put Vidaza at the top of their list. The Hutch has been using Vidaza more than Vanderbilt, as have several facilities the last 10 years or so. Our friend Kathy suggested it as an option since her team in Atlanta has been using it, as well, and Vanderbilt had it on their option list. Vanderbilt will administer the Hutch’s recommendation here. No travel is necessary.

This means Dori will not receive a second transplant. The doctors in Seattle and at Vanderbilt and my family now believe Dori essentially underwent a second transplant in July. Her intense GVHD (graft versus host disease) this summer suggests her donor “Hans” took a brief break before he realized he wasn’t supposed to. Thankfully, he hopped back in the saddle. Interestingly, we’ve heard this "last minute to-the-rescue" thing is rare, perhaps happening in 1% to 2% of cases like Dori’s. We are fortunate Hans got fired up again.

Candidly, I didn’t want to see Dori endure another transplant, and neither did she. If she needed to have one, she would have been her normal gritty self. But her body has been through a great deal, and we’re relieved she can pursue another course.

Vidaza has been around a while, perhaps 30 years. Studies have shown Vidaza keeps GVHD at bay, but doesn’t hinder GVL (graft versus leukemia or graft versus tumor, which we want). Vidaza also keeps open all options– including another transplant or DLI (donor lymphocyte infusion) – if necessary.

That’s not how we’re approaching it. We’re looking at about six months’ regimen of Vidaza, more prayer and clean living. Dori has begun tapering steroids and cyclosporine, which has been sorely needed. Steroids wear out the body.

Dori starts Vidaza Monday. God be with her, every step and every moment.


Ann said...

Praying along with you.

ChuckEastNashville said...

Lots of prayers here too.