The Diagnosis - Bringing You All Up to Date

While Jack was hospitalized for cardiac by-pass surgery we became increasingly concerned about the large numbers of unexplained bruises on Vicki's arms and legs. A blood test showed that all three of her blood cell types (red cells, white cells, and platelets) were abnormally low.

Jack returned home from the hospital last Sunday. On Tuesday morning Vicki had a bone marrow biopsy. A second blood test showed a further decrease in her blood cells. While waiting for the results of the biopsy her fatigue and bruising increased. Yet another blood test showed that her blood counts were continuing to decrease.

On Thursday evening she was admitted to the hospital. She received a preliminary diagnosis, which was confirmed on Friday. She has a form of leukemia called acute promyelocitic leukemia (APL). APL is caused by a specific translocation between parts of two chromosomes. This translocation prevents
myeloid cells from developing into mature white blood cells, leading to an abundance of abnormal, immature cells. The cancerous cells eventually crowd out the healthy blood cells needed for the body to function normally. Here's a link to an article on Wikipedia which will give you more information.

Treatment
On Friday Vicki began treatment with a substance that comes from vitamin A called all-trans retinoic acid (ATRA). She has also received a transfusion of platelets and will likely receive more as her treatment continues. She will begin receiving chemotherapy on Monday and receive it daily for seven days. After receiving chemo she will need around two weeks to generate enough healthy blood cells. She will be hospitalized throughout this treatment.

Prognosis
This treatment is aggressive so the coming weeks will be rough, but according to The Leukemia & Lymphoma Society APL "is the most curable form of AML" (acute myelocitic leukemia).

Although it's certainly not good news, we were relieved to learn that it is not metastatic breast cancer, which was our greatest fear. There is a small risk of developing this type of cancer as a result of some of the medications Vicki required to treat her breast cancer, but most cases of leukemia cannot be traced to a specific cause and Vicki's doctor says this is probably not related to her breast cancer treatment.