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Nearing the End of Part A

Posted by Frederick Wasti
Jun 28 2012

Yesterday (Wednesday, June 27th) was just another, pretty routine "regular Ofatumumab day" at Dana-Farber. I seem to be able to handle the Ofatumumab pretty well now, all things considered - the side effects seem to be slightly less each time, and I felt not very "beaten up" at all on the way home. So, I guess "routine" was the word for the day.

Yesterday's blood test results also seem to be a bit "routine", too, in a way. At least, they do not seem overly different from the last couple of weeks, and my previous "Bottoming Out ?" feeling seems to still be valid. Admittedly, the ~details~ of what is going on in the blood, in the lymph nodes and spleen, and - maybe especially - in the bone marrow, are all still unknown to me, and those details could be ~very~ important, but the "big picture" numbers seem to be rather stable (if that's the word for it).

Here is how the total white cell count since diagnosis looks:


It does seem that, over the last few weeks, the total leukocyte number has been hovering around 10, 000 per microliter. That is not bad news, of course - hovering around the upper limit of the normal range is a whole lot better than approaching almost 60,000 per microliter, as I was doing just a few months ago. (And, it's also a good thing that the point of starting treatment is so easy to spot on the graph.)

Looking at the percent of lymphocytes since diagnosis...

...does show that the lymphocytes are down into a normal range, keeping in mind that lymphocytes normally make up approximately 30% of the total white cells. However, I still don't know what proportion of my lymphocytes are leukemic cells.

The neutrophil percentage, which had declined since diagnosis, and which seems to have been approaching "bottoming out" before treatment started...

...now looks quite good, considering that neutrophils are supposed to make up approximately 60% of the total white cells. In other words, the neutrophil news is all favorable. And, unlike my lymphocytes (where no one at the moment knows how many are normal and how many are leukemic, and how effective they might be at detecting foreign bodies in my tissues), presumably all of my neutrophils are normal, and ready to do ~their~ job of fighting off bacterial invaders.

Part A will be ending soon. I have one more (hopefully routine) "regular Ofatumumab day" coming up next week (although it will be on Tuesday, since Wednesday will be the Fourth of July). And, on Friday I am scheduled to be back at Dana-Farber for a full day - blood tests, a CT scan, a bone marrow biopsy (BMB), and a meeting with Dr. Fisher. The CT scan results may be available to Dr. Fisher in time for us to discuss them, but the BMB results will not be fully back for a couple of weeks (although some of the results may be available sometime the following week).

Hopefully the CT scan will show that my lymph nodes and spleen, which had all seemed to have improved during the first half of Part A, will continue to be in good shape (and I honestly do expect that to be the case). The state of my bone marrow, on the other hand, is more in the realm of the unknown. It remains to be seen just how much improvement there has been over the past few weeks, and the BMB results will help clear this up. Time will tell...

Then, Part B will finally begin the following week. For Part B, I will still be receiving Ofatumumab, but only on the first day of the each of the six 28-day cycles (instead of once each week, as in Part A). The big change in Part B will be that I am to start receiving another monoclonal antibody, Alemtuzumab, given by injection, three times each and every week of each cycle for six months. I'll have more to say about this new drug pretty soon.

Categories: Leukemia