Diagnosis?

Remember the record book discussion about the number of tissue biopsies? Well, we got some information today. The purpose of the last biopsy was to gather Cytogenic and Molecular data to help doctors make a subtype diagnosis and develop a treatment plan. Pathologist are looking for particular Chromosome and/or Gene abnormalities to place patients into risk categories, Most Favorable, Intermediate, and Least Favorable. Typically, a specific DNA marker is found and you are slotted in a group. Carla is not typical. There was not a marker which pointed Most Favorable or Least Favorable, so they placed her in Intermediate. In patients with AML, usually 60% have chromosome abnormality, Carla does not have abnormality. Now a test on me would surely show that I am one DNA translocation from a pre-historic specie. Although she is responding well to treatment, they are unable to specifically subtype Carla and in good conscience must use the Intermediate category.

What does this mean? Normally it means people may have to consider a bone marrow transplant if treatment plans are unsuccessful and higher relapse rates. But for Carla, she does not have the markers or symptoms which normally require transplant and the team of doctors are monitoring her before any other types of treatments are considered other than her scheduled 5 rounds of chemotherapy.

Status: In typical fashion, during her blood infusion today, Carla has more questions about the doctor's pregnancy and trying to "hookup" one of the male PAs with a friend than she has about her own illness.


Jonni - Thank you for the gift shop contraband "What the Hell!" sign. We still wake up in bewilderment with this on our mind.