Nuff Said

There’s an old saying that goes something like this: "Sometimes, you have to kiss a lot of toads, before you find your prince.” Now, this doesn’t apply directly to me, since A) I was never looking for a prince in the first place, although if you replace “prince” with “princess” I have already scored in that category, even though Jill is more like a queen than a princess; and B) my reason for bringing this whole topic up has nothing to do with princes or princesses, it has to do with leukemia and stem cell transplants and lab tests, and stuff like that. Still, there is some truth in that old saying that was engendered of fairy tales. 

The following is not a fairy tale. When we last left our story, I had just had a Bone Marrow Biopsy (BMBx) and a nice long nap. Today, I received the second of two reports of the results of that BMBx. The first report came a couple of days ago. That report addressed something called Chimerism. "Chimerism is a rare condition where a person or animal has two or more sets of DNA from different sources.” (Source) In my case, the two sources were A) my parents and B) my stem cell donor. The significance of this test for me is that, in order to get rid of my leukemia, I needed to get rid of my bone marrow, which was diseased and producing cancerous blood cells. Chemotherapy got rid of the cancer briefly on several occasions, but it didn’t get rid of my bone marrow cells, which had some sort of problem that allowed the cancer to return. 

Enter my stem cell donor, reportedly a young, healthy man who was eager to come to my rescue. After chemotherapy and radiation therapy prepared my body, I received the stem cell donation, which of course, has the donor's DNA. The theory is that the healthy donor cells will not only provide healthy bone marrow, but also a new, more potent immune system that not only takes over the function of my own (host) cells, but in fact eliminates any remaining diseased marrow cells. In other words, a clean slate. Or at least that is the operating premise for the stem cell transplant. 

The Chimerism test is to see if that actually happened. The report from the OHSU pathologist says: 

ENGRAFTMENT POST TRANSPLANT

NO HOST DETECTED

That is a GOOD result. No (bad) host cells were detected, only (good) donor cells were detected. 
So, the transplant successfully replaced my bone marrow. Now on to the second test result. This result came from a private lab, apparently a contractor with Kaiser Permanente. The results are as follows: 

Myeloid Malignancies Mutation Panel NGS Submitted diagnosis or diagnosis under consideration for variant interpretation: Acute myeloid leukemia, unspecified (AML unspec)

TIER 1: Variants of Known Clinical Significance in Hematologic Malignancies

None found 

TIER 2: Variants of Unknown Clinical Significance in Hematologic Malignancies 

None found

The genetic testing for leukemia activity found NONE. So the transplant not only replaced my sick cells, it also killed off any signs of leukemia. So, after kissing a lot of toads in the form of several kinds of chemotherapy, I guess I found my prince, or at least a prince of a guy, who donated stem cells so that I could have a transplant and these marvelous lab results.

I’M CURED!!

Nuff said.