Good morning, Kathy. AML can get worse very quickly if not treated. You mentioned that the return of mutated MPN1 cells were first seen in the BMB and now in the peripheral bloodwork. Myeloblasts aren't typically found in the circulating blood of healthy people. By the time that happens, it’s generally from overcrowding in the bone marrow and these over-proliferating cells are being pushed out into the blood stream.
It would be difficult to know how much time you have left but you’ll get a little better idea of this with your next 2 or 3 blood tests. It will show a trend in how quickly this escalating.

I respect your decision and your pragmatic approach to this. In all honesty, I felt this was an easy exit too…but I wasn’t ready yet and decided to fight the battle of a lifetime. (And it felt like it! LOL) But I can also understand if you’re not willing to go through all that chemo again. I’m here anytime you want to talk about it with the same level of pragmatism.

Your hematologist oncologist would be the key person to provide a timeline for you. It would also be important to discuss the end game strategy with your doctor. If you’re choosing no treatment. it will be important to decide whether you’ll forgo transfusions as you become more anemic or if you’ll opt going to hospital if needed. Do you have a DNR Medic Alert bracelet?

Kathy, do you have friends and family around?