January 8, 2009

I spoke with Tom's doctor today. While the doctor was analyzing Tom's bone marrow biopsy there were several "clues" that arose:

1. Tom's bone marrow is not functional
2. There were a predominance of lymphocytes (AKA T-Cells) in his blood
3. The T-Cells were good in terms of their number and proportion between those that were helper cells and those that were suppressor cells

They ordered a T-Cell Gene Rearrangement test to examine whether the T-Cells appear to be cloned. We should know these results between the 13th and the 20th. The T-Cell Gene Rearrangement test will be utilized to rule out Adult T-Cell Lymphoma/Leukemia (http://www.wrongdiagnosis.com/a/adult_t_cell_leukemia_lymphoma/intro.htm). Once this is ruled out the doctor expects to make a diagnosis of Aplastic Anemia. Whether or not it is Hepatitis Associated or not the treatment will be the same. He will undergo a bone marrow transplant.

The doctor has also submitted a request to our insurance group to begin the bone marrow transplant process. This approval should be received by the 22nd, hopefully sooner. There are several factors that I am aware of that affect the success of the transplant:

1. Donor match (the key being the greatest number of blood protein matches – most likely found in siblings)
2. Time (completing it ASAP)
3. The number of blood transfusions (The lower the number the better, I’m not clear yet as to whether that means before or after the transplant or both)
   
   http://www.rush.edu/rumc/page-1124119149290.html
   http://cpmcnet.columbia.edu/dept/medicine/bonemarrow/bmtinfo.html
   
   I’ll leave it at that for now. Thank you again for your overwhelming support.
   
   With love, Barbara