The biopsy from back on my birthday shows significant infiltration of the bone marrow by the more aggressive of the two lymphomas that I had before. This pretty solidly explains why my blood counts have been so low; there isn’t any room for the bone marrow stem cells to operate properly. In fact, the pathologist reported that it was difficult to spot any stem cells in the sample at all!

My spleen is bigger, but not as big as last time. Some lymph nodes are bigger, but not as large or as widespread as last time.

In addition, there may be some water around my heart. I’ll be getting that checked out further to see how that will impact treatment.

Today is my day off from medical stuff. Tomorrow, a transfusion and an LP to make sure it hasn’t spread back into my brain. The next day: into the hospital for heavy duty chemo.

And when this new type of chemo wipes it away, I’ll probably be getting another stem-cell transplant. The scarier type this time.

One thing that was quickly clarified: we had in mind that the heart of the process would take 90 days. Bzzt! Wrong! That’s for allogeneic transplants, where the donor and the recipient are not the same person. Fortunately, that’s not what I’m doing. The type of transplant we’re starting up should take more like 30 days. Some take less, some take more.

It sounds like everyone is actually pretty sure that the extra radiation of my brain is a good idea. We’ll be meeting with a neuro-oncologist on Friday to check out the results of tomorrow’s MRI.

In the last week I’ve: had a physical, recounted my entire lymphoma history, declined to participate in some studies, had some blood drawn, and had my teeth examined. Coming soon: MRI, MRSA check, PET/CT, bone marrow aspiration and biopsy, and pulmonary function tests. Some of these are to make sure that the cancer is in remission, and some are to make sure I can handle the transplant conditioning.

And yesterday reminded me that when I say “the cancer is” I actually mean “both cancers are”. I met with the attending doctor for my team and he noted that stem cell transplants have been found to be curative for more aggressive cancers (like the one that was found in my nervous system), but that the slower-moving (indolent) one may still (just barely) survive.

On the plus side, indolent cancers don’t seem to develop resistance to treatment as quickly. And if they do get resistant to specific attacks, there is still a broad spectrum of treatment options. And more on the horizon.

For now it is important that the radiation and that transplant totally destroy the aggressive lymphoma. All energy toward that goal.