Doctor,

The Doctor Called.

We spoke with Dr. Meyers on the phone this morning, as planned.  It's always educational and a tad frightening to have a discussion with the experts.  Details slip out that feel like new information but really, it's just information that wasn't forthcoming in previous discussions.  Nevertheless, the news is good, today.  

Today's discussion introduced the P53 gene.  

    Here's the official description (looked it up after our conversation):

        p53, also known as TP53 or tumor protein is a gene that codes for a protein that regulates the cell cycle and hence functions as a tumor suppression. It is very important for cells in multicellular organisms to suppress cancer.

Last week, Jolynn had a couple of extra blood tests designed to divulge information about the amount of old (MDS) cells in her blood and the amount of the new (Jan's) cells in her blood.  Dr. Meyers told us that, in her blood, she has 100% new cells.  Excellent news!  The bone biopsy that was done on Tuesday retrieved cells from her bone and when those results are in, we will then know the percentage of old cells and new cells in her bones.  The experts will specifically be looking for P53 in her bone cells.  We should have those chromosome results in about 10 days.  This will be an extremely important finding in the research of whether Jolynn is completely rid of the MDS or if there are any remnants of MDS still left in her body.

Jolynn reminded the doctor on the phone that we were told a few months ago that all of the cancer was gone.  
                    Silence

Then, Dr. Meyers reviewed the story of "blasts" with us.  She told us that healthy people have around 1 - 2% blasts in their body...baby cells, officially called "myeloblasts"; i.e. immature cells in the bone marrow.  Jolynn has "less than 4% blasts" in her bone marrow, according to the recent biopsy.  When we first embarked on this journey back in October, Jolynn was diagnosed with 7% blasts with high risk MDS.  We learned that Acute Myeloid Leukemia (AML) usually has at least 20% blasts.  Since then, we have also learned that AML can be diagnosed if the blasts have a chromosome change that occurs in a specific type of AML even if the blast percentage is less than 20%.  So, we are holding our breath, waiting for the chromosome results of the bone biopsy test.  We went into this chapter knowing that a bone marrow transplant was not a guaranteed cure.  Thus far, though, the results are good.  Her blood numbers are amazingly normal.  No obvious GVHD to date.  The good news comes with a shadow of doubt circled round it but we remain hopeful.

About GVHD.  Dr. Meyers reiterated that the drug Jolynn takes faithfully at 9am and 9pm, Tacrolimus, is keeping Jan's new cells "asleep.".  Around Day Plus 60, Dr. Meyers will start to back off the Tacrolimus, slowly waking up Jan's new cells.  It is at this point that GVHD could start to unravel......or not.  

Today is Day Plus 49.  We are skating around on thin ice, but we have warm cocoa and ear muffs and we are watching for cracks.

Dr. Meyers ended our call with the encouragement for us to go ahead and get that Thai food take out next weekend, a little earlier than the 60 day mark, but with instructions on how to be safe. 

My eyes have seen the years.

                               https://www.youtube.com/watch?v=x0GhjlmlEwQ