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In yet another turn of fate, the game board has been flung skyward.

I spent the first part of the week at the hospital getting tested for my fitness to endure an autologous stem cell transplant. The good news is that I am a picture of health, passed all my tests with flying colors.

The bad news is that I am experiencing an aggressive recurrence of the lymphoma. All bets are off.

This is not quite all the way back to square one, but close. There will not be a transplant unless we can get to remission. In the mean time, I will undergo yet another “salvage” regimen in hopes that we can get the cancer under control. There are two primary options to choose from once results from my bone marrow and neck biopsy come back.

The likeliest is a drug called Romidepsin. Unlike my prior therapies, this one will be done locally, one day a week for 4-5 hours. There will be two cycles of this, each cycle consisting of three weeks on and one week off.

The good news is that this therapy is supposed to be very mild on the side effects and is far less toxic than standard chemotherapy. (This is a newer generation of drug.) It has a good track record in general, though again, the rarity of AITL means that there is insufficient research to indicate whether my cancer will respond.

It is something of (another) leap of faith. The good news is that it will give me about two months to clear the previous chemo sludge out of my system. If I am not in remission after the two cycles of Romi – or if the biopsies come back with something unexpected – we will move to another chemo cocktail or perhaps a clinical trial of some sort. None of this is good news, though at least I still have some options for treatment.

Our transplant doctor was blunt: “You have a very aggressive form of cancer, and no good options.”

Thanks, doc. On the other hand, our oncologist is not quite so fatalistic, you should excuse the expression.

The odd thing is that I feel pretty good aside from some ongoing fatigue issues and a sore spot in my hip where they removed some stem cells and bone for the biopsy. (Not as bad as it sounds, but almost.)

So the saga continues. Thanks again for the music and books and cards and emails and such. I appreciate you all. I owe a couple dozen thank you notes and return phone calls and such. Damn, y’all are good friends.

I’ll post again when I have more news. Until then…