Help ... Vidaza question?

[bailie]

I just finished my 5th cycle of Vidaza. My reds, whites, HGB and platelets "bottomed out" after the 2nd cycle and have been steadily improving. Platelets have steadily improved from 20 to 116.

The question/answer that I don't understand is my blast count. I would think that the blast count should be improving in relation to the increase of the other counts. But, the blast count has stayed almost exactly the same through four BMBs.

The problem is that I am getting close to transplant time with no improvement of the blast count and I realize that is not good.

[DanL]

Bailie,

One of the theories on Vidaza or Dacogen pre-transplant is that it may "chemosensitize" your cells making them more receptive to the ablative conditioning, lessening the problem with higher blasts. Like anything in MDS, this is not a guarantee, nor hard science, but it is a working theory. The idea of any pre-transplant therapy is to reduce the tumor burdern, which if you are seeing improvements in your blood counts, there is some evidence that Vidaza is successful in that area at least.

Your doctor may have a different opinion, but there is growing evidence of the benefit of pre-transplant Vidaza or Dacogen, and quite a bit of evidence supporting induction chemo as well, but generally not both as this tends to weaken your body too much.

The key is to go in with a strong, positive attitude, help your mind understand that you are going to do everything that you can along with your doctors to defeat this disease, and take each day as it comes, sometimes changing the definition of victory to fit your day.