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75 year old father just diagnosed with AML
Blood Cancers & Disorders | Last Active: Jun 8 9:53am | Replies (22)Comment receiving replies
Hi Lori,
Today we met with my father's doctor to go over his treatment plan. We learned the chemo will be a combination of Venetoclax (pills for 14 days) and Vidaza (shots in stomach for five days) starting this coming Monday. The shots will be given at the VA Hospital, but he will not stay there as long as everything goes well, and he tolerates it. I read and followed several of the links you provided me, and I was hopeful this would be my father's treatment plan, due to several posts from people saying how effective it was in conjunction with being more tolerable for the patient. The rapid genetic test showed he has a FLT3 mutation, which I know is not good news, and he has 53% blast cells in his blood (we are still waiting for the full genetic testing profile). The doctor talked about a medication that targets the FLT3 cells; however, it sounded like he's going to wait to see how my dad responds to the first round of chemo before adding that treatment regimen to my father's therapy. He said he will do another BM biopsy in 4 weeks and plan the next step. The doctor said my father is not eligible for a BMT at the VA, due to their policy being a maximum age of 75; however, he said he would make a referral to UW Hospital, should my father respond favorably to the chemo, but he said "in his heart" he didn't feel any doctor would consider my father for a BMT (it hurt, but we appreciated his honesty).
Thanks again for everything! I felt better prepared for today and more knowledgeable because of you.
Ryan
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Good morning, Ryan. I’d been wondering how your dad’s treatment plan was developing. I think the last time we spoke Greg was waiting for the genetic report. He has the same acquired FLT3 mutation that set my journey into motion. I added 2 more mutations just to keep my doctor’s on their toes. LOL
FLT3 can be a challenging mutation to deal with however, as your dad’s doctor mentioned, there is an abrogating drug targeted to the FLT3 mutation that works well. It was also added to my treatment plan.
The first step is to knock down the cancer cells. So it’s important for Greg to begin his chemo program to stop the proliferation of the blasts. The meds he will be receiving have a good track record in helping get the disease under control. I think because of his age the chemo is scaled back a little to a less aggressive form that’s more tolerated by the body. As our bodies age, they don’t process drugs as well through the liver and kidneys. I was 10 years younger than your dad at the start of my treatment and was admitted to the hospital for 5 weeks in the beginning. My induction chemo and subsequent sessions were as inpatient with Cytarabine and Idarubicin infusions for 7 days in the hospital the first time and then just Cytarabine every 28 days for 3 months. I’ll admit it was pretty brutal. Now, thankfully there are meds such as Venetoclax and Vidaza that are much better tolerated but still effective and don’t require a lengthy hospital stay.
The abrogating drug is Midostaurin (Rydapt). I took it for 21 days following each chemo round, tolerated it well and was so grateful that the drug was available. It was a newer drug then and getting approval from Medicare took a call from my doctor.
As you probably figured out already, I’m all about information. 😉 So I found a good article for you about the FLT3 mutation which mentions Midostaurin and it’s mechanism for treating this mutation.
https://www.healthline.com/health/aml/flt3-mutation#symptoms
Your dad will feel some changes coming up in the next couple of weeks as the chemo starts working. Fatigue is normal (and frustrating for active people!) Because his immune system is seriously compromised it’s really important that he avoids exposure to infections and illness. Masking is a good idea around people in public settings. Think “covid training”…the rules still apply. Also, no gardening because of the risk of exposure to fungal infections.
Give your dad my best wishes as he starts his treatments! He’s got this! Keep me updated please. Hugs…