In the Waiting Room

My final session of chemotherapy (known as R-CHOP) was completed at 1:00 PM on August 17th. The event passed without any fanfare--mostly because none of us knew it would be the last. So there were no good-byes to the staff, no gifts, pictures, etc. Here is what my last "Breakfast of Champions" looked like:

Despite any rumblings that may occur in your, or my, stomach at the sight of these, this is not your father's chemotherapy. I must give kudos to the infusion staff and to Dr. Vinnie Juneja for minimizing much of the potential discomfort of this experience. In many respects, I was able to continue with the regular aspects of my life.

Meanwhile, also on August 17 (give or take a few days), 3,000 miles away, Dr. Josh Brody and the MCL research team at Stanford received approval from the FDA to commence a Phase I study to apply a previously developed vaccine to the treatment of Mantel Cell Lymphoma. In anticipation of all of this, back in April, we spent a day in Palo Alto visiting the hospital and leaving enough blood to construct my own version of the vaccine. The vaccine was made and resides in a freezer somewhere in the vicinity.

So the next chapter in all of this will include administration of that vaccine with a contemporaneous "reconditioning" of my immune system, also known as an Autologous Stem Cell Transplant or SCT. (Used to be called a bone marrow transplant, but technology has overtaken that aspect. It is no longer necessary to invade my skeleton for marrow. Stem cells are, instead, extracted pretty simply from my blood in a process called Apheresis.) The SCT will remove most traces of my lymphoma and place my immune system on a new and rejuvenated footing. The vaccine, which is administered before, during, and after, the transplant will teach my new T cells to recognize and destroy any newly forming MCL cells.

The Vaccine/ SCT process will begin sometime between October 30 and November 24, as soon as the "T Cell" component of my blood returns to pre-chemo levels, to allow the vaccine the greatest opportunity for success. It will take the better part of three months. I will spend most of this time in Palo Alto.

For the fraction of the population that finds such things interesting or have asked for progress reports, I will try to post regular updates of my adventures as a research vehicle. As a warning: inappropriate humor may appear from time to time, as well as a few "bad" words if they describe my condition best. Thankfully, due to a predictably diminished libido, there will be no sexually explicit content!

In the mean time, while we wait, I am learning my way around the blogging machine, working as much as the economy permits, and enjoying the waning days of the golf season. Jane and I are honing our compartmentalization skills and imagining trips to far-away places in a simpler time. The Girls (Molly, Shannon, Joanna) continue to handle things well. Max, the dog, sleeps.

Although I enjoy this process of writing, I don't have any really good words to describe the wonderful support expressed by so many people along the way, and what it has meant to me and my family.

Mike (10/13/09)