Tuesday, July 19, 2011

TWO YEARS + 48 DAYS: about MAC

Top Line: GVHD treatment on autopilot while the docs figure out the MAC attack

Susan an Bob were at Dana Farber yesterday to meet with Dr. Soiffer, her transplant doc and case manager, and with Dr. Francisco Marty, an oncological pulmonologist who is addressing the MAC (mycobacterium avium complex) issue.

The main purpose of the visit was to explain the additional medications Susan must now take and to get an early read on how her body is dealing with and responding to the new meds. At this point there are no issues, but it's early days and too soon to determine how effective this starter protocol will prove. Treating MAC, especially for a recovering transplant patient, is as much art as science, and will require continuous monitoring, primarily via blood work, with the possibility of minor to major adjustments in Susan's drug regimen. Once the right formula is in place (and it could even be this starter protocol), Susan should experience a notable improvement in her cough within 1-2 months. However, the medications will likely need to be continued for a year or more.

Susan is scheduled for a followup assessment in three weeks. At that visit she will also see an opthamologist at Mass General who will administer a serum that may help with Susan's eye problems. Yes, we said that tuning the GVHD treatments was being put on hold, but they must nonetheless be continued in a stable fashion (so as not to interfere with the interpretation and adjustment of the MAC treatments). This particular serum, however, has been determined not to have any potential conflicts with the current GVHD or MAC regimens, so it's worth trying now, given how uncomfortable Susan's eyes are.

Return to this blog in 3 weeks for an update on Susan's next DFCI visit.

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