ONE: Continue with this protocol. Because some of the numbers are so close to remission, Dr. Horton feels Johnny can continue this protocol -- it seems to be working, he's responding, why rock the boat? He would get a high dose of methatrexate on Monday, and probably repeat cycle two (which he's doing right now) until the transplant team has the donor prepared -- approximately 4 weeks. Dr. Horton will have to plead Johnny's case to the leukemia team and get their approval-- but only if the other test results are close to remission numbers.
TWO: Super aggressive. This is a trial that hasn't been approved by Baylor College of Medicine (TCH) yet, other hospitals are using the protocol, just not TCH. Approval for this protocol could take up to 10 days. This super aggressive path has really bad side effects like septic shock (no thank you) or death (we'll pass). Neither one Mike or I are ready for. But if you can make it past those two obstacles, you go to transplant and have a pretty good chance from that point on.
THREE: Aggressive. Clofaribine will be the only chemo and is extremely hard on the marrow -- recovery could take months -- which might also give the cancer time to come back as well. But if this one goes smoothly, Johnny will go to transplant when finished with this protocol.
FOUR: Go home with oral meds to keep the cancer at bay for as long as possible, with no chance of transplant. This option isn't even an option because the cancer would take over within two maybe three weeks. Every time he's had to stop treatment the cancer came back and progressed extremely quickly.
FIVE: Comfort care. Same results as four, but much, much faster, instead of weeks, it would be days. Neither are an option for us.
So that's what we are up against right now. I'm also going to check St. Jude's and MD Anderson to make sure we have exhausted all other treatment plans.