New Treatment -- Mylotarg

Dear Fods,

Hi everybody! I am sorry to be late getting back to all of you. We saw Dr. Porter last Monday and he was concerned with my counts and he looked at my blood under the microscope. Unfortunately, he saw leukemia in my blood. He did the dreaded BMB and said that we needed to change the course of treatment from dacogen to a new drug. The dacogen may have stopped working. He is also concerned that the dacogen may have caused my hearing loss.

I was scheduled to be admitted on Monday morning to receive mylotarg which is called a monoclonal antibody. This is a targeted chemotherapy drug which goes directly into the leukemia cells. Somehow the BB 33 antibody from the mylotarg attaches to the BB 33 antigen that is only found on the surface of the leukemia cell. The drug then enters the leukemia cell and destroys it. This drug is intended for older patients who cannot tolerate the "big gun" chemotherapy anymore.

Before we found out about this new leukemia regime, we had long planned a Pocono weekend with my girlfriends from ICU. Mentally, I needed this break and I knew that I will be out of circulation for a while after this new treatment. Jessie and Allison were bringing the kids down for a visit because I will have lousy counts for the next month or so as I recover from the mylotarg. Mo, Bev, Lee and I went up on Friday afternoon. It was glorious, the leaves were in full color and it was cold. Some of the other nurses came on Friday night and we had a "whooping" time. Picture 18 nurses in their 40's, 50's and 60's. On Saturday morning, the surgery nurses came with Jilly, Bonnie and Kathy Moore. We had a hearty breakfast and more laughs and then I headed home to see the grandbabies.

We had so much fun with the kids. We went to our local farm and did hay rides, haystack mazes, sliding boards, and we picked up some pumpkins. It was a blast. Pop Pop carved 3 pumpkins for the kids and they enjoyed them a lot. They took them home with them on Monday. We came home and did more crafts, painted by numbers, made cupcakes and told stories. Izzie is almost walking. She takes about 5 steps and then sits down. Any moment now she will be gone. She still never cries and sleeps like a champ. Christian and Emma are getting cuter every time I see them and it is fun to read them stories to get them to sleep at night. Allie left Monday morning and Jessie stayed to see what was going on with Penn. But as of noon time, HUP did not have the BMB results so we had to sit and wait at home.

It took until 3:00 PM to get the BMB results and they were not too good. There was 35% blasts in my blood which is not good. We came in an were admitted by 5:00 and then waited until 11:00 for the chemo to arrive in the room. You have to be an inpatient for this chemo because the infusion can cause an allergic reaction causing high fevers, rigors and nauseau. Despite being pre-medicated with tylenol, benadryl, zofran and steroids, I had all of the reactions. They started the infusion at 11:30 and I did fine until 3:00 AM when all hell broke loose. I had terrible rigors, vomiting and my fever went to 104. My nurse Kelly was right here but it took a while to get things under control. Of course, then I needed blood cultures, urine cultures and a chest X-ray to make sure there was no infection -- and there was none.

I was hoping to go home today, but just now got my temp down to 100. I am hoping to go home tomorrow, however, my liver functions and uric acid levels have bumped a little -- but this is expected with this drug. Dr. Porter is being his old cautious self but is taking good care from me. The drug comes with very strong warnings from him not to fool around with the fevers once I get home because this drug can cause large drops in your WBC.

Please say a prayer that I can stay out of here. Your prayers have kept me going for the past three years and I am convinced of that. I am supposed to have another BMB next week to see what the mylotarg accomplished and then they will decide if we get another round of the drug.

Of course, the house is torn apart now with the painter in the living room, foyer, etc. I did not want to cancel him -- but Joe is none too pleased about HUP and construction at the same time.

Congratulations to Colin to be on the homecoming court and Brendan -- yes the pressure is on! Mer -- congratulations on Madrid. Spain is beautiful and what a wonderful experience. I wish that I could come along. Visitor Allison have a great time in Vegas and we hope you hit the big jack pot. It seems that you had a good time this summer with relatives from Ireland visiting. Kris -- enjoy the Colorado weather before the snows come. I hope you had a good time in Hawaii at your nephew's wedding. Cheryl -- your girls sound wonnderful, you must be so proud. Not to worry, I think that you will have grandbabies before you are 60. Glad you like you job.

To everyone else, thank you so much for your beautiful cards and calls. Enjoy this great weather and I (Joe) will write again soon.

Love to All,

Debbie