Tuesday, June 21, 2011

Fwd: James Uyeki has sent you an UpToDate topic

I spoke to dr. Fukumoto today and asked him a bunch of questions.
Basically we need to get the results of the bone marrow biopsy to
determine if she is considered having high or low risk cytogenetics.
If considered low risk, the plan Dr. Fukomoto recommends is to first
get a complete remission thru induction chemo (using the protocol as
noted in the below up to date article).  Once achieved, she will have
another biopsy prior to starting consolidation chemo and then will
undergo three chemo treatments (one per month, 5 days in hospital for
each treatment) using  Cytarabine.  This regiment is needed to
completely rid the body of any remaining leukemia cells and should
result in complete remission.  If AML reoccurs after this remission, a
bone marrow transplant is recommended (BMT).

If the results of the biopsy show that she has a high risk
cytogenetics, then we may want to send her to a cancer center to
determine the appropriate protocol for her.  Traveling should not be
risky as long as we have her in remission from her induction chemo.
BMTs have many risks associated with them.  Sibling stem cells would
be the best option for matching purposes.

Regardless, she will have to pull out of school for the fall semester
and will not be able to work as her body will be susceptible to
infection so will need to be kept indoors while undergoing chemo.
Unfortunately, Kauai does not offer immediate transfusions (blood must
be flown in from Oahu) so is not a good option for her rehab during
consolidation chemo :(.

Stan, I do not have Dr. Uyeke's email, so please forward to him.

Sav is experiencing some nausea from the chemo and has a sore throat
(still).  Otherwise her spirits are good....getting tired of being in
the hospital.  Feel free to call or email her to help keep her
occupied!

Love to all,

lil' Tami
Sent from my iPad

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