At 8pm last night Allistaire began her chemo. For thirty minutes she received Fludarabine through her IV/Hickman Catheter. Later, at 11:30 she had a four-hour infusion of Cytarabine. She will have this same chemo regiment for the following four nights. In addition, she has seven days of GCSF shots which started the day before she began chemo and will end the day after her chemo is complete.
So here’s the cool thing, not that I really understand it, but it is still SO amazing! God made this sea sponge, Tectitethya crypta, that has its happy, beautiful home in the Caribbean. One day in the 1950’s, somehow it came to pass that some folks were able to isolate two nucleosides from this unassuming creature. These nucleosides contained an arabinoside sugar rather than a ribose sugar. In our human DNA, a cytosine base usually combines with the sugar ribose, but in the sea sponge, cytosine is combined with the arabinoside sugar. What is the point? Well, the amazing thing is that this combination of cytosine and the arabinoside sugar is similar enough to the combination of cytosine and the other sugar, ribose, that the sea sponge combo can be incorporated into human DNA but it prevents the synthesis of the DNA – which in turns kills the cell! Sweet!!! Do you get it? Put something in the body that looks like it belongs there, sneak it inside like a Trojan horse and BAM – put a cog in the wheel and down, down comes the big monster! This is the infantile history of Allistaire’s chemotherapy, Cytarabine. Doxorubicin and Etoposide, two of her chemo drugs from her first time battling AML, came from the American Mayapple and some soil-based microbe in Italy, respectively.
Back to FLAG, which is the name of this chemo protocol for relapsed AML. The “F” in FLAG, stands for, “Filgrastim,” the brand name for the GCSF shots. GCSF stands for Granulocyte colony stimulating factor which in simple terms, causes the bone marrow to rapidly produce white blood cells. Allistaire received her first GCSF shot on Wednesday evening at 6pm. Wednesday morning, prior to the shot, Allistaire’s ANC was 1420. Twenty-four hours later, her ANC shot up to 11,724. I had to do a double-take when I read that number – I mean I’ve never seen that many digits. Often these shots are give to people who have non-blood cancers, after they are given chemo, to stimulate their marrow to make the white blood cells that protect against infection. With folks like Allistiare who’s very marrow is the source of cancer, they are left vulnerable with no white blood cells, until their marrow heals on its own. I was a bit confused when I heard that Allistaire’s cancer treatment would begin with making more cancer cells as a result of these shots. As I understand it, it is all a matter of timing. Because chemo works most effectively against rapidly dividing cells, this speeding up of cell production in the marrow, actually allows the chemo to more effectively target and destroy the cancer cells. Basically, you get the cancer cells to start dividing like crazy and then hit it hard with that cog in the wheel that is especially adept at taking down the speedy guys and before you know it – you have a battlefield littered with dead bodies – guts all spilling out, lifeless. That’s the goal.
I know for at least a few of you, you will never make it to even reading this paragraph because your eyes are crossing and your brain is melting and glazing over with all the numbers and funky names most of us have no clue how to pronounce. So, for tonight I won’t go on to the piece about the clinical trial Allistaire is enrolled in. I’ll save that for another night. But may I challenge you just a bit? Push yourself to think about it. Feel the ache of your mind trying to grasp such details. Let yourself feel the annoyance of being overwhelmed with confusion. Force yourself to consider the complexity. When you do, when I do, we are taking the tiniest taste of God’s glory. Don’t deprive yourself. Eat. Drink. Soak in the wonder of what He has done. Let your mind’s eye see the innocent sea sponge shimmering beneath clear blue waters. How long has it lived there on the bottom of the sea harboring its beautiful secrets. Yes, I feel the ache and searing pain of dwelling in a creation fallen by sin and cursed. I hated to hear Dr. Pollard say that Allistaire could have been born with the MLL (Multi-lineage Leukemia) chromosomal rearrangement that was the precursor of her cancer. I hate that we are born broken. But see that purple, rippling below the waves? We are not only curse. The earth is not only broken and hurt. It is bearing the beauty and life of the One who created it. At the very moment of the curse in Genesis 3, there was also the promise of redemption, of life. He has not walked away. Look up. Look out. Be alert. Beautiful life may be hidden where you least expect it.