After the first of what would be three bone marrow biopsies, I got a call from the clinic with my results. My bone marrow was normal. Now this is a very abnormal – if not unheard of - finding in a person with leukemia. People with leukemia typically have at least 20% abnormal, underdeveloped white blood cell levels in the marrow. My abnormal cell count was 0. Anything below 5% is normal. What did it mean? No one knew.
Bone Marrow is the soft, spongy tissue that fills the empty spaces in your bones. It makes:
Red blood cells that carry oxygen to your organs and tissues
White blood cells that fight infection
Platelets that help your blood clot to stop bleeding
Dr. Rangaraju said she had never seen anything like this. She consulted with other oncologists/hematologists at UAB who were equally flummoxed. She searched PubMed (as did I) and other sources for cases like mine. She found none. So how would they treat it if my bone marrow was normal? How would they know if treatment was working? All of the doctors agreed that the standard treatment was the right approach – despite my being a unique case. A friend of mine who has a connection with a specialist at MD Anderson Cancer Center talked with him about my case. He said he agreed with my doctor’s approach but if I needed him, he’d be happy to see me. At our next appointment at UAB, Dr. Rangaraju discussed treatment. She leaned forward, looked me in the eye and said, “We treat to cure”. I said, surprised and stunned, “Do you mean this is actually curable, not just treatable?” I had a hard time wrapping my mind around that.
Not knowing much, I had always thought of leukemia as being eventually fatal. I had grown up with Love Story in which Jenny, the young, tragic heroine played by Ali McGraw dies from leukemia (they never say "leukemia" in the movie, but the clues are there). In one of the last scenes, we see her lying in the hospital bed, her shining, raven hair falling across her pillow creating a halo effect. How she kept her hair, I have no idea since most people with leukemia have chemotherapy that causes hair loss. She was still beautiful despite her impending death.
But Dr. R explained to us that there had been an upsurge of research and progress over the past few years in many cancers – especially blood cancers. Stem cell transplants, targeted drugs, and CAR T-cell immunotherapies are making cures possible. She warned that the treatment would be long and arduous. It’s one of the most difficult treatment regimens of all the cancers. Of course, the tradeoff is you get to live.
For the first time in weeks, I felt hopeful. But there was still one question that Dr. R was investigating. And it started in Philadelphia.
Next blog: The Philadelphia Story
Beth Kitchin PhD RDN
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