Monday, December 21, 2015

Chimera






St. Mark's lion is not the original Chimera, a mix of lion, serpent and goat, but it seems to be a chimera of a lion and a bird. The Venetians placed these all over as a symbol of their power
 
tufted titmouse
sunrise yesterday
downy in the squirrel proof cage
Maya and Allie creating art
the grandbabies are becoming harder and harder to photograph as they never stay still

After a stem cell transplant, the bone marrow is tested regularly (very painful to extract) to see what percentage is from the donor versus the host.  In my friend's case, this is made easier as her donor was her brother so they just have to monitor the Y chromosome. She showed signs of engraftment early on with the new marrow churning out red and white blood cells and platelets to normal levels. Although these levels are still good, a recent bone marrow test showed the donor percentage at 76%. At Day 100, it should be very close to 100%. A very early test had showed 86% engraftment which was higher than expected.                   Furthermore, they saw no signs of her botched up cells which are missing a chromosome. She is extremely anxiously awaiting a new test that hopefully shows the last test to be in error somehow.
 
What could be happening? The worst case: her fast growing leukemic cells are displacing her brother's healthy cells.  Before transplant, a month of chemo reduced the bad cells from 17% (20% is considered full blown leukemia) down to 2%, which is considered to be very good. They won't do a transplant above 5%. The blast (very heavy duty chemo) should have killed all of her bone marrow but there is no way to test that.  Presumably they can see if the remaining 26% are her deformed cells or maybe some surviving healthy cells.
 
Relapses are unfortunately common though she had a better chance than most of not having one. The treatment recommended would be another transplant which was so brutal, I can't imagine she'd go through it again.
 
Leukemia was the first success in the War on Cancer. Chemotherapy was successfully used in childhood leukemia , which was 100% fatal in a short time without chemo to 30% in a much longer time frame. This number is probably better now as I am using an old Merck Manual. Most childhood leukemia however is ALL whereas older adults have AML which is treatment resistant beyond a short remission with chemotherapy. Bone marrow transplants (now known as stem cell transplants) are their only hope.
 
I have been scouring the internet for hope. One lady had 4 transplants before she was cured. Another young woman, Naomi's age who was diagnosed at 18, is in chemo purgatory. She has only 90% donor cells. To keep her numbers climbing above 10%, she is permanently on chemo which has many side effects plus might stop working at some point. She wants to go off it and enjoy a chemo free existence. Who knows? Maybe the leukemia won't come back...
 
But maybe all this worry is for nothing (I did look up the error range: unfortunately low).
 
I have wondered if being a chimera would have any implications in crime and indeed it has. A woman was brutally raped and murdered but the killer's DNA was all over the place and was quickly matched. The alleged killer had a good alibi: he was in prison! However he had provided cells for a stem cell transplant to his brother......
 
Many of us are chimeras. Fetuses inject bits of their DNA into our blood streams, even unborn ones. What are the medical implications? The source of autoimmune diseases much more common in women? There are some positive aspects too with fetal cells glomming up to repair various tissue injuries. Research is in progress.
 
It is raining on my parade. No pretty sunrises today, just wet gloom. Maybe I will waterproof myself and go for a needed walk anyway.

2 comments:

Elephant's Child said...

I hope you did get that walk.
Leukemia strikes home today.
A blogging friend's niece died a few days ago. Fifteen.

Sue in Italia/In the Land Of Cancer said...

While it was only misting, I got a long walk in before it started to pour again. Had to stay away from the slippery hills.

So sorry about your friend's niece. Even under the best circumstances, the treatment is brutal and doesn't always work.

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