Tough Choices

When I was a little girl, I used to love to watch the game show, Let’s Make a Deal, and the host would ask the contestant to choose between what was behind Curtain #1, Curtain #2, or what was in The Box. It was always a gamble. Sometimes they would get a car. Sometimes they would get a camel.

When I was first diagnosed, Paul and I were very confident about the direction we were going to take for my treatment. We had done the research. We knew the risks. We knew we were choosing the aggressive option, but we were confident that it was the right decision. And we were right. My doctor confirmed that just a couple weeks ago. Even though I am no longer in remission, my stem cell transplant bought me three years and apparently got my 17p deletion under control.

Now my stem cell doctor and leukemia doctor have offered three different treatment plans for consideration. Knowing us as they do, they told us to go home and research all of them and we would discuss the pros and cons next Monday at my appointment with my stem cell doctor. Mother has been going to all of my appointments with me these last months, but Paul will be going to this one as well. Paul has begun the in depth research as he always has in the past and I have started mine. We have talked at length. But so far we do not have a clear answer on this one. The risks are rough on all three. I have ruled out one because it has a tendency to lead to Richter’s syndrome, which is what led to the death of my buddy, Dave, so I simply just can’t.

The DLI (donor lymphocyte infusion) is different than the stem cell transplant in that only lymphocytes or T-cells are used…not the whole cell. Not only do they help fight infections but they are also able to recognize abnormal or cancerous cells and kill them.

The DLI is an effective treatment for minimal residual disease and to treat mixed chimerism, meaning that most of my cells are donor cells but some are still my old ones, which need to go away!

The DLI sounds like it would be the obvious choice, but it has a very high risk of GVHD (Graft versus Host Disease). There was the risk for this with the SCT as well, but not as high as the DLI because there is no chemo used in this procedure. Some GVHD is manageable. Some GVHD is life threatening. It is a lot to consider.

The leukemia drug, a targeted therapy, would simply manage it, not cure it. But the side effects are brutal. Or I could do nothing and wait until my leukemia is worse and take my chances on enjoying quality of life.

So do we take what’s behind Curtain #1, Curtain #2, or what’s in The Box? Please be praying with us. Pray for clear guidance from God. Pray for peace in whichever decision we make. We had that the first time. We are praying for that this time.


“Make me know Your ways, O LORD; teach me Your paths.
Lead me in Your truth and teach me, for You are the God of my salvation;
for You I wait all the day.”
Psalm 25:4-5

“Let me hear Your lovingkindness in the morning; for I trust in You;
Teach me the way in which I should walk; for to You I lift up my soul.”
Psalm 143:8

“I will bless the LORD who has counseled me;
Indeed, my mind instructs me in the night.
I have set the LORD continually before me;
Because He is at my right hand, I will not be shaken.”
Psalm 16:7-8

“I will instruct you and teach you in the way you should go;
I will counsel you with my loving eye on you.”
Psalm 32:8