A Man with a Plan
After two CT scans, an echo-cardio, a biopsy, countless blood analyses and some discussions, I am now a Man with a Plan. (No, not that kind of plan. Read on!)
For relapsed T-cell lymphoma, the basic plan boils down to get me into complete remission and then do an allogeneic stem cell transplant.
(I’ve had an autologous stem cell transplant in November. That was necessary to get my systems back up and running after a high dose of chemo. This time, the mechanism is different: I will get someone else’s stem cells and those are supposed to go chase my cancer cells.)
OK, so that clearly leaves us with two simple questions:
- how to get me into complete remission?
- where to get a stem cell donor?
For both of these questions, the plan is clear now. I will participate in a study with an experimental medicine to get into remission. This one is part of the ‘smart medicines’ that target specifically the cancer cells and should leave the rest of my body alone. (Nice side effect: less side effects, as the rest of my body is more or less left alone. So, hopefully not the nausea of last time…) It’s pretty interesting stuff actually: a class of so-called “PI3K inhibitors” interrupt the communication line within the tumor cells. That means that the message to replicate doesn’t go through. So the cell doesn’t replicate. So the tumor doesn’t grow. Which means that it eventually dies. And leaves my body. Good riddance.
For the stem cell donor, we’ll first try my sister and brother, who each have a 1/4 chance to match with me. (You may want to take care of your family bonds if you’re not so close with your siblings…) If neither works, we’ll try to find a donor in an international donor bank. Probability to match with an arbitrary individual: 1/50.000. But, as a privileged (in so many ways) White Western Man, my chances are apparently quite good.) Still, it’s really nice if you want to donate – do go ahead and register (in Belgium or elsewhere) – but you can’t be tested for me specifically. (Nice of you if you considered that though!)
That’s the plan. There are some risks. Hey, it’s an experimental medicine. And allogeneic stem cell transplants are not without risk. But it’s good to have a plan.
And what does a man with a plan do? He executes. So, I’m writing this from my hospital room, waiting for my first dose of copanlisib… And guess what they just brought? Here we go! Start of Round 2…