Induction Chemo

[katiebear]

My dad went for his BMB on Tuesday after spending almost 4 weeks in the hospital doing induction chemo to get into remission to continue on with a SCT. He got the results yesterday. His blasts went from 50% to 12%. The doctor wants him back next week for more induction chemo, only this time stronger. I am very worried. Has this happened to anybody else? I could sure use some positive feedback.

Thanks,

Katie

[jaxem]

typical for some hospitals to spend 4 weeks for induction. how old is he? do you know what regimen they are using? did he get through initial chemo OK? you’ve got to get closer to remission if the sct is going to work. my wife went through 2 induction chemos but at same concentration. the 2nd round did nothing but hold her to 1st round level.

[katiebear]

My dad is 66 years old. He came through the initial chemo pretty well. He had a bout with chicken pox, and an infection in one toe. He only ran a fever one day. I don’t know what regimen they used. I know they used two drugs, and this time he told me it will be even stronger. He doesn’t get a whole lot of information for me to work with, nor does he ask too many questions. He did say that at this point this is his only option. He is very weak and tired also. He has to get a test on his heart to make sure that the first round of induction didn’t damage his heart muscle. I will try to get more info on the regimen. I’m glad to see your wife is down to 5% blasts. I hope she’s able to get the SCT.

Thanks,
Katie

[lynette]

Hi Katie,
Both times my Mom had chemo, either in the form of a clinical trial or traditional induction, her blasts went significantly down during the first round. She opted for a second round both times. The doctor explained to us that without the second round, the leukemic cells would quickly return, and the decline in blasts would return to where she started.
Lynette

[katiebear]

Lynette,

Thanks very much for your response. I talked to my dad a little while ago, and his counts are even worse. He is going into Sloan tomorrow for a test on his heart, and if that checks out okay, then they will admit him on Wednesday for another round of induction. It makes me feel better that other people have gone through this and made it. Hopefully this second round will do the trick, and he can go onto the sct.

Thanks again,
katie

[Jack_dup1]

Katie,
I hope all going well, I know you will keep us posted and thoughts and prayers are with you, Dad,
and family.
Jack

[katiebear]

Jack,

Thank you for your prayers. My dad’s heart test went well today, so he is able to get the second round of chemo. He is being admitted to Sloan early tomorrow morning. When I visit on Saturday, I’m going to get the exact combination of drugs. I know he said it’s stronger.

Thanks again,
Katie

[lynette]

Katie,
Please be sure that you follow your Dad’s heart status closely. While my Mom made it through the 2nd round of the first clinical trial, she did not survive the 2nd round of the second induction. Her Ejection Fraction, a measure of the heart muscle function, dropped from 71% to 16% in one week. The Daunorubicin has a cummulative toxicity on the heart muscle. My Mom went into heart, then kidney failure. Please be persistent in asking the doctors to monitor his heart function. My thoughts and prayers are with you ans your Dad.
Lynette

[Bkwits]

Katie,
I will also be praying for your dad and sending positve thoughts your way.
Barb

[katiebear]

Barb and Lynette,

You have no idea what your advice and prayers mean to me. I can’t put it into words. I had tears in my eyes when I read your posts. I will keep you posted.

Thanks,
Katie

[jaxem]

lynette

you’re right!! chemo drugs are tough. my wife was given adriamyocin following breast surgery which caused her mds and i believe caused her ejection fraction to drop from 60% to 25%. she routinely sees a cardiologist along w/ the hematologist who adjusts her drugs (lasix & coreg) accordingly.

katie
good luck w/ your dad. my prayers go with him. feel assured that he is at a great medical institution where my wife will be getting her transplant once she gets into remission.

[katiebear]

Jack,

I just got off the phone with my Dad, and he is getting a MEC regimen. The drugs are Mitoxantrone (Novantrone), Etoposide (VP 16), and ARA-C. I noticed that your wife went through MEC. How did she do? My dad also said that it only has a 20% success rate. I’m sorry to keep picking your brain, I don’t know where else to go.

Thanks,
Katie

[jaxem]

hi, katie

the M & E might have done some damage to her heart ie reduced the heart’s pumping power called injection fraction (output blood flow divided by the input flow to the heart). going in, an echo done put the fraction at 55%; following the MEC, it was 15-20%. a lot of water built up around the lungs making it difficult for her to breathe & her heart labored. she was put on lasix which removed the water. not sure if the M and/or E, or the adriamycin she had been given following breast cancer surgery did it. the M & E are tough drugs! it brought her blasts down from 18% to 8%. following about 3 months of convalescents, her blasts rose again to 18%. she then had 2 rounds of FLAG therapy (fludaribin, ARA-C & growth drug (neupogen)which reduced the blasts to 5%. still not good enough for a cord transplant, she started on one round of vidaza, then switched to dacogen. she just completed her 3rd round of dacogen.

keep picking my brain; my head is fat enough as it is. good luck & my prayers go with your dad.

[katiebear]

Hi Jack,

I went yesterday to visit my dad. Friday night, he was running a fever of 102.5. He scared us all. They did a catscan, and it turns out he has some fluid in his intestines near his illium. They said it’s colonitis. He has to rest him bowels for 24 hours, so he can’t eat. He still seems in good spirits. The doctor came in and gave him some paper work to sign on using a MUD instead of his sister as she is now 60, and they don’t feel her marrow is vibrant enough. I also told him to ask the doctor about the Dacogen and Vidaza that you suggested. I wonder if you can use Vidaza again if it already stopped working? Again, thank you for responding to me, and I hope your wife is well and I continue to pray for her.

Katie

[kami]

Jack,

If I can pick your brain as well…as you are the closest thing i have to an unbiased doctor.

We just found out last night that my dad’s MDS has transformed to AML…with 40% blasts in the marrow. Our options are the usual…inductive chemo at UCSF, or for him to fly to MD Anderson, and partcipate in one of 2 trials

1.)daco+vorinostat
2.)clorfarabine via IV

he is 76 and in pretty good shape…

Dr. Ravandi has made a point that there are no absolutes for any of these options as far as the response rates are concerned(some do really well and some don’t)…but they are very promising nonetheless.

He mentioned that induction therapy(if he’s in good shape) has a good outcome for many as well…i’m just worried about the physical toll it will take on him.

what do you think?

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