Well it doesn’t look any lovelier outside today but my heart feels a bit lighter – I have VERY good news!
Allistaire is FLT 3 NEGATIVE!!!!
I know, I know you’ll just have to tear up all those “Down with FLT 3” signs you’ve been making. Okay, so probably you have no idea what I’m talking about. I’ll attempt a novis’ explanation. There is a spectrum of AML that is determined by various differences in the leukemia cells. The FAB (French American British) categorization created designations labeled M0 – M7. As I understand it these are based on the proteins found on the exterior surface of the cell. In Allistaire’s case she is either M5 or M7 – they haven’t been able to determine which and may never be able to do so. Morphologically (as in how it looks under the microscope) she is M7 but cytogenetically (the chromosomal changes) she is M5. In part of the genetic tests that they have completed they found a specific translocation on Chromosome 11 which is more common in M5. M5 is made up of monoblasts which are cells that normally become white blood cells called monocytes and macrophages. M7 is the subtype also known as acute megakaryoblastic leukemia. The cells are megakaryoblasts, which normally mature into megakaryocytes (the cells that make platelets). According to one site I looked at, M7 is given the worst prognosis possible. While it is still true that in comparison to some subtypes such as those with AML M0- M2 who tend to have good prognosis, M5 & M7 have their challenges such as fibrosis in the marrow. However, in the last 10 years they have learned that these subtypes are not as significant in determining prognosis as the underlying cytogentics – these are the changes that take place at the chromosomal level. So at last I introduce to you the insidious, evil doing FLT3. I actually don’t know a thing about FLT 3 except during the sugar plum fairy dance at the Nutcracker last night, all I could think of was FLT3, FLT3, FLT3. What I have been told is that FLT3 can significantly worsen the prognosis. So I praise the Lord for this news that Allistaire is FLT3 negative. If there happens anyone out there however, who reads this who has the same weighty fears of FLT 3 that I have been living with, please know that they are studying a target-chemotherapy Sorafenib that specifically addresses FLT3. More importantly consider the following:
I began reading and reading, asking question after question. Turning the words of the doctors over and over in my mind in an attempt to understand the realities at work in Allistaire’s body. This comes from a sense of responsibility to know what’s going on – to be informed. But you know what else, it’s also a search for peace. You start reading and you read things like “positive prognosis, ” “dismal prognosis,” “relapse,” etc and you find yourself caught up in the details – in the numbers. You know from the first day that only 60 – 70% of AML patients live and you think, “but 30 – 40% die. That would be fine if I was planning a hike and I was hoping for good weather but this is my kid.” Then you learn that not only does your kid have cancer, they have the rare kind, the bad kind and you start to feel the weight pile on. You look and look, website after website, question after question for the good news that says, there is hope. You do need hope. I need hope. I want to put my hope in science, research and these absolutely amazing, kind, wonderful doctors we have. But what do you do when the research tells you it doesn’t look good. You feel despair coming upon you like a cold damp suffocation, pressing in on you, cutting off your airway. I don’t want to hear that Allistaire has the worst case scenario. I genuinely praise God for this place, for the research that allows for all the treatment and support that Allistaire is receiving and for the compassion, determination and knowledge of our doctors. Ultimately though, this cannot be the source of my hope. My hope is in the living God – creator of the universe from all the way out beyond the deep, magical Milky Way and Dark Matter down to Van der Waal forces and even smaller. My God is the creator of it all – He holds it all in His hands. He is a God that is able and good. I know that God can heal Allistaire. I know that He may not. This is not hard for Him. Bring it on you wretched FLT3 – you are no match for the Lord of all Creation – the Ancient of Days. M5 or M7 – it doesn’t matter. It is as if I asked you, “Can you pick up this staple?” And you would respond with audacity, “Of course I can.” Then I say to you, “But oh, can you pick up this paperclip? It is ever so much bigger than the staple.” You would think me ridiculous – why? Because the weight of a staple or the weight of a paperclip – they don’t matter – they are utterly insignificant to the might of your strength.