← Return to MDS diagnosis with DDX41 Germline and Somatic

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Profile picture for Lori, Volunteer Mentor @loribmt

Good morning, @asarnesejr. Well, my friend, you have a lot to chew on today after your meeting with the bone marrow transplant team. I know there was a ton of information tossed out to you yesterday and I’ll do my best to help you sort through it.

After reading through your concerns a couple of times I really think you’re most worried about what your life would be like after a bone marrow transplant. If all goes as planned, most of us return to a near normal existence.

From my own experience, my life has returned to, I’d say, 98% of my ‘normal’ life. I have developed close friendships with other BMT patients over the past 7 years, along with members here in MCC. Depending on where we are post transplant, I think we’re all pretty much just going about our lives as routine now. Certainly there are risks vs rewards that need to be weighed. There have been significant advancements in the prevention of graft vs disease complications since I had my BMT almost 7 years ago. So waiting to go ahead with this can have advantages.

However, I will say, that the first year post transplant is a lengthy recovery period often stretching into year two. Meaning fatigue can linger and recovery will involve of frequent doctor’s appointments and blood draws. If your risk score is super low, that means the likelihood of developing a more aggressive blood cancer remains low. Has your team discussed the possibility of other treatment options instead of a transplant?

Also, from information I’ve read, your DDX41 mutation has been recently linked to more a favorable response rates and long overall survival with chemo than with the allo transplant. My Mayo transplant doctor is also involved in cancer research. He and his cohorts have published papers on the DDX41 mutation and that was one of the findings. I think I’ve shared that information with you before. https://www.nature.com/articles/s41408-023-00818-6

There are other members in Connect who also have this mutation and have been referred to DDX41 specialist at Mayo. They’ve shared their stories with you as well.

@fortuitous posted this comment a while ago.
https://connect.mayoclinic.org/comment/1089183/
Along with @sherbs in this comment https://connect.mayoclinic.org/comment/1476612/

Honestly, if I were you, I’d just try to put this in the background and get on with your life. The term waiting and watching is anxiety producing. It’s like you’re just waiting for the other shoe to drop. Active surveillance is much more appropriate. IF, over the years, things change and you need treatment, THEN you will deal with it. People have BMTs into their 70s. But for right now, all this worry and stress is robbing you of some wonderful retirement years! It’s ok to get the information and a potential plan for the future. But from my own experience, live in the present! Each day is a gift and when you focus only on ‘what if’ then you’re losing precious moments.

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Replies to "Good morning, @asarnesejr. Well, my friend, you have a lot to chew on today after your..."

@loribmt The transplant team did not discuss other options besides stem cell transplant. Honestly, it was 90 minutes of everything that will probably go wrong with the SCT. They told me they perform 150 SCT a year and I'd have a 50% chance of survival. Besides the chemo killing me, the stem cells may not take, I may have GVHT. Even if the SCT team considers it a success, I could end up on kidney dialysis, liver damage, heart damage (or attack), retina damage, and always more susceptible to colds and recovery from such.... just to name a few I could remember.

They really did not say anything positive about the SCT process or outcome. My wife was with me as a second set of ears.

Is this the reality of it? That once my numbers go low the SCT is prolonging my death sentence. Or is this the doom and gloom speech they have to give to cover themselves?

I'm even more scared than I was initially, and did not sleep much last night