Today was the big CT scan result day that would determine if Kim is a candidate for the stem cell transplant. We had all got ourselves into a very binary frame of mind. Either today would be excellent news and Kim would start a treatment that would hopefully end this whole mess or it would be very bad news. We were not prepared for an answer that falls in the vast grey area between those two extremes.
The two rounds of R-GDP reduced Kim's cancer by about 43%. This is good, but not good enough to do the transplant. However, because it is close, they are "giving her the benefit of the doubt." They are going to proceed with the stem cell collection as planned over the next few weeks. Then Kim will get a third round of R-GDP back at St. Michael's and then they will scan her again. The goal is to get the cancer to at least a 50% reduction. Assuming this happens the high-dose chemotherapy and stem cell transplant will occur later in June.
Today Kim started the mobilization chemotherapy that will facilitate the stem cell collection. This occurred at PMH and went extremely smoothly. They are super-well organized there. She goes back tomorrow and Friday for more treatment and then next week is a resting week. The target collection day is still May 30th.
The benefit of doing the collection before the third round of R-GDP is that we get the cells collected and stored without rushing and they will be ready to use as soon as the third round is done. Also the fact that PMH is willing to invest time and resources to do the collection before the treatment suggests they think the extra round will be successful.
The mobilization chemotherapy is composed of two drugs. The first is cyclophosphamide which is the 'C' drug from the original R-CHOP regimen. However in this case it is given at dose that is three times stronger. The other drug is etoposide which is a drug Kim hasn't received before but is used to treat Lymphoma in other parts of the world. The important thing is that the mobilization chemotherapy will also help treat the cancer so it's not like Kim will be taking a break from treatment to do the stem cell collection. There will still be drugs fighting the disease.
Waiting is so hard. Now we have to wait longer. At least the R-GDP made had a good impact on the cancer so far though. 43% is a good number.