Acute Promyelocytic Leukemia (APL)

Today (Friday April 29) we got the official information we have been waiting for, Mark's diagnosis. Mark has Acute Promyelocytic Leukemia (APL). Basically, one day while his white cells were making new white cells bad white cells was made due to a chromosome abnormality in the 15th and 17th chromosome. At that point, the bad white cells could no longer mature, which means they would not die. Therefore, Mark has lots of young, bad white cells in his body that won't work the way they are supposed to and also won't die.

According to all the doctors, if you had to choose a leukemia to have, this is the leukemia you would choose. According to the Leukemia and Lymphoma Society literature I am now reading instead of my homework, patients with APL are among the most frequently cured. The oncologist today, Dr. Holland, said about 90% of APL patients achieve remission, which is the best percentage of all the leukemias. The doctor did make sure to let us know that not all APL patients get remission, but the odds are definitely in our favor, especially since Mark is young, it seems we caught it early, and his body is healthy otherwise.

So, let's talk treatment. Turns out, according to the doctors, the treatment for this leukemia is generally a little better than the other leukemias too. Mark started taking ATRA (All-trans retinoic acid) on Wednesday evening. ATRA is only used with APL. The ATRA is basically a REALLY hyped up Vitamin A pill. He takes 5 ATRA pills, 2 times a day. ATRA causes the immature, bad white cells to mature so they will die and therefore decreases the number of leukemic cells in his body. As of right now, he will take these pills for 60 days, everyday (today is day 3).

The second part of treatment is chemotherapy. Mark starts his chemo called Daunorubicin at 10:00 in the morning. He will get chemo tomorrow (4/30), Monday (5/2), and Wednesday (5/4). This will wipe his system clear of the good and bad white cells, and practically everything else in his blood like red cells and platelets. Then his system will gradually rebuild with good white cells. The whole cycle is supposed to take about 4 weeks. Once his system rebuilds and his white cells are at an acceptable level, Mark gets to go home. He will continue to take the ATRA for the full 60 days (June 25th to be exact). Then we move into the next phase, which is outpatient and we will learn more about it later.

Now, the doctor did inform us of side effects such as severe headaches, nausea and vomiting, increased chance of blood clots, increased risk for spontaneous bleeding, temporary hair loss and more severe, yet less likely side effects that we will only address if we have to address them. Mark is having pretty severe headaches, nausea, and some vomiting, which make him feel pretty miserable at times. The nurses are very responsive to treat his symptoms and side effects and consult with other nurses and doctors when they feel it is necessary.

So, we are staying positive. We are blessed because Mark's diagnosis and treatment are the best options we could have asked for under the circumstances. We are in a great hospital with kind, caring, knowledgable doctors, nurses, and techs. We have wonderful family and friends who are really stepping forward and practically begging to help us in any way possible. Thank you so much for your prayers and servant hearts during this trying time truly a witness to those around us. It will be very stressful and difficult at times for the next several months, but God will pull us through it all, and we will be better and stronger in the end because of this experience.

Amanda

P.S. Many of you have asked about donating blood. Dr. Holland, the oncologist said blood donations are great but they really need platelet donations. Platelets only stay in your body about 10 days, so when you  have trouble making new platelets due to something like leukemia, you need platelets very often, and it takes several units of platelets to help an adult. Also, platelets only last 5 days after being donated, so new platelet donations are always needed. Finally, if you go to a blood donation center and donate blood, they separate the blood into platelets, plasma, and red cells and get a little of everything. If you donate platelets specifically, you get all your other stuff back into your system and they get lots of platelets. Anyway, if you are interested in donating to the pool of platelets that they get Mark's platelets from call Atlanta Blood Services at 404-459-8744. This is a simple, free way you can help Mark numerous times during his treatment.