- 6/6 donor (46/female/US) - mismatched at HLA-A allele, DRB1 antigen, DQB1 antigen (too many mismatches)
- 6/6 donor (22/female/US) - mismatched at HLA-B allele (best)
- 6/6 donor (46/female/Europe) - mismatched at DRB1 antigen, DQB1 antigen (too many mismatches)
- 9/10 donor (39/female/US) - mismatched at HLA-B antigen (2nd best)
What this means is that none of the donors are a full 10/10 match, but the #2 donor (22/female/US) is the best match since she only mismatches at a single HLA allele (an allele is sort of like a sub-component of an antigen). Unfortunately, mismatching at an HLA-A or HLA-B allele isn't so great, since it's been found to be a significant factor for the occurrence of graft-versus-host disease after the transplant. In larger studies a mismatch at either of these has been shown to reduce overall survival rates. So while everything could still go perfectly fine, basically the odds go up that there will be complications. There is a discussion going on between the transplant physician and my doctors to see how we will proceed. The main issue is whether to risk using a 9/10 donor now to get to transplant quicker or waiting for a better donor and risking the disease progressing to something worse.
Also, I had another platelet transfusion on Saturday (whoopee) which seems to be par for the course now (a transfusion a week after the end of every chemo round), so now that the chemo is done and the transfusion is out of the way, the next 2-3 weeks should be pretty normal again. I’m scheduled for another marrow biopsy 2 weeks from now and we will decide whether to do another round of the same chemo, or go with induction therapy, which is a very intensive form of chemo that may require in-patient care. The purpose of induction chemo is to get the disease into remission to bide more time.
Johanna and I are thinking it might be time to organize a marrow drive to see if we can get a better donor.
That’s it for now.