I have been spending the last few weeks reading over your blogs and have decided that it is time to join in. On March 4th my husband was diagnosed with CML in blast crisis. He had been complaining of night sweats and tiredness for about a month. He is a retired war vet with PTSD so night sweats were not uncommon except that they were getting more frequent. He had been on vacation all of February with his family in Puerto Rico. He came home on 2/27 and spent the whole week end in bed. He was due for some blood work and went into the VA to have it done on 3/4 (his birthday no less). A few hours later he received a call saying that he needed to return to the VA that they found something in his blood and would need to be hospitalized. So I left work and took him to the VA. We were met by a hematologist who explained to him that his white blood cells were way too high and that he was severely anemic. She told us that he had Leukemia and that he was being referred to Roswell Park Cancer institute. Fortunately we live in Buffalo NY. So he was admitted to Roswell and by the end of the next day he began chemo.
His initial BMB stated this:
Bone Marrow Touch Imprints and Core Biopsy:
Chronic Myeloid Leukemia in Myeloid Blast Crisis, showing 35% myeloblasts in a hypercellular marrow for age (90% cellular) see comment. Peripheral Blood Smear: Leukocytosis with circulating myeoblasts (28% blasts), neutrophil left shift with occasional pelgeroid forms, absolute basophilia, normocytic anemia and thrombocytopenia.
Comment: preliminary cytogenetic studies report a complex karyotype in addition to the presence of t(9,22) with 45,XY, add (8p)?t(8p;22q), t(9;22),add(16q)/t(16q;17q),-17 in 6 cells. the blasts are negative for CD34, TdT, PAX-5, and positive for CD117. Molecular studies for p190 and p210 transcripts are pending.
Apparently his BCR-ABL chromosome did a disappearing act during several tests and he also has other issues going on with his chromosomes. So they have sent his BMB to the mayo clinic for a second opinion with more sensitive testing.
As for his treatment so far he has received Cytarabine and Daunorubicin Induction (7+3) which was round the clock for the first seven days and in addition to that he is receiving Dasatinib 140 mg. every day. He has been battling pneumonia which apparently was something he picked up in the hospital and has been going on for almost two weeks. He has had some very high fevers....last night it was 105.98! They keep assuring me that once his numbers bounce back he will be able to kick the infection. He had another BMB on day 14 which showed significant treatment related changes with markedly decreased hematopoises, increased plasma cells, stromal and cell distribution and estimated to comprise approximately 5% of the cellular marrow. Correlation with cytogenic studies is suggested. So they are now waiting for his numbers to bounce back. As of today his wbc is 0.62 up from 0.2 a few days ago. His hemoglobin today is 7.4. He will have another BMB in about a week if his numbers have bounced back sufficiently. We are looking towards a bone marrow transplant. He has six siblings. 3 have already been tested and were not a match....we are waiting on the results of the other three.
So after all of this information I have two questions. Is there anyone in the network who has been diagnosed in blast Crisis? Does anyone know how to read the initial BMB? I understand the gist of it but am interested in any in depth information that can be given.
Let me just say that I have read several of your blogs and admire how you have all armed yourselves with knowledge. The camaraderie and support you have all shown to one another is truly awesome!