My first round of maintenance therapy began on Tuesday. This is a big milestone but also just another small step toward getting back to normal-ish.
For typical ALL patients intensification involves vincristine IV and doxorubicin IV and peg-aspargase every three weeks until the max dose of doxorubicin is reached. Then it is switched to weekly methotrexate. In addition to this, We take two weeks of oral chemo and five days of high dose steroids each cycle.
Unfortunately, as I have mentioned before, I could not tolerate the peg-aspargase and so this was not part of my intensification regimen. It caused me to develop acute pancreatitis so we decided to continue without it. Typically once the maintenance phase is reached this would be discontinued anyway.
Maintenance for me will continue to include vincristine IV every three weeks, methotrexate weekly, mercaptopurine (oral chemo) for 14 days each cycle, and five days of steroids at a much lower dose. The lower dose of steroids, I’m hoping, will be the game changer. I will be happy if I have fewer withdrawal symptoms such as exhaustion and pain.
So far I’m feeling good since starting this first round but it’s only been a few days so it’ll be a bit before I know how I will tolerate maintenance. It’ll be two years of treatment, that’s so crazy to think about. Two years of this seems so daunting but I know that it is necessary to keep the leukemia away.
In other news I was able to get my first COVID vaccine last Friday the 23rd. I got the Pfizer vaccine so I should be getting a second dose within 21-28 days. However, most if not all provinces have been delaying the second dose by up to 4 months! This delay can result in an extremely low immune response in cancer patients and those with compromised immune systems. In addition to this we are at higher risk of complications if we were to contract the virus.
This is a work in progress and many of us have been advocating for changes to the rollout. I really hope we can get some more movement on this front.
On that note, wish me luck as I keep trudging along the long road that is cancer treatment and trying to live my life to the fullest. It’s not always easy, but I do my best to stay positive and keep my chin up.