Hodges

In Memory

Marlena

Patient Information

Age: 24

Sex: Female

Diagnosed: 1/05

Location: Virginia

Diagnosis: Stage III DSRCT

Hospital:

Oncologist

No evidence of disease: 5/4/05

Relapse: 6/17/05

No evidence of disease: 1/17/06

Relapse: 12/13/06 - Lesions to the brain

Passed away: 7/27/07

Caringbridge Journal

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Treatment

Surgery

Debulking surgery with 90 minute heated chemo bath (Intraperitoneal hyperthermic chemoperfusion) done by Dr Paul Sugarbaker.

Received a hysterectomy, splenectomy, greater omentectomy, a right colectomy, numerous lymph nodes in the abdomen were removed, gallbladder removed, diaphram was scraped, and tumor was removed from liver.

Chemotherapy

• First Line:

Carboplatinum and Gemzar

Daily Gleevec pills

• Second Line:

Ifosfamide and Etoposide

Vincristine, Doxorubicin, and Mesna

Stem Cell Rescue

Fludarabine and Melphalan high dose chemo

Allogeneic stem cell transplant. Received brothers stem cells.

Granulocyte donor (white blood donor) - husband matches.

Takes approximately 14 days for the new bone marrow to engraft

Radiation

18 different Fields (most people have only 2-4 Fields) and one treatment takes an hour. It stops 18 times for over 30 different “shots” of radiation that last about 15 seconds each. About 2/3 through the process have to be lined back up so they can do pelvic region. 4 weeks in the abdomen/pelvic area and 7 weeks on neck region (lympth nodes)

Relapse

Cyber Knife

Time Line

Date	Test	Treatment	Chemicals	Result
1/5/05	0	0	0	Diagnosed. CA-125 marker was 1030. (normal is 30)
2/8/05	0	Debulking surgery and intraperitoneal hyperthermic chemoperfusion.	0	5 1/2 weeks in the hospital to recover from surgery.
2/12/05	0	Chemotherapy	Carboplatinum and Gemzar 1	0
3/05	CT	0	0	Clear.
3/05	0	Chemotherapy	0	Once a week for three weeks with one week off. Daily Gleevac.
4/05	0	0	0	0
5/4/05	CT	0	0	Clear. No evidence of disease.
5/25/05	0	Chemotherapy Cycle 1	0	0
6/17/05	Exam	0	0	Enlarged lymph nodes in the neck (measured 3.5cm). Relapse.
6/05	CT	0	0	"Shading" or marginal tumor growth in abdominal area, nothing solid.
6/05	0	Chemotherapy Cycle 2	#1 Ifosfamide and Etoposide (given over 4 days) - #2 Vincristine, Doxorubicin, and Mesna (given in 1 day)	0
7/05	CT	Chemotherapy Cycle 3	0	Lymph node in neck measures 1.6cm
8/05	0	Chemotherapy Cycle 4	0	0
9/17/05	CT	Chemotherapy Cycle 5	0	CT scan revealed significant shrinkage (1.3cm) - no more fluid around the lungs
10/05	0	Chemotherapy Cycle 6	0	Shrinking.
11/05	0	Chemotherapy Cyle 7	0	Dirty Harry still shrinking. :-)
12/05	0	Chemotherapy Cycle 8	0	Dirty Harry gone.
1/17/06	CT	Chemotherapy Cycle 9	0	CT scan clear except for 3cm cyst on bladder. No evidence of disease for all lympth nodes.
2/06	0	Chemotherapy Cycle 10	0	0
2/28/06	MRI	0	0	No sign of tumor anywhere except the cyst on bladder and a nodule that may be dead tissue
3/8/06	PET	0	0	Fistula (small pocket of fluid) behind bladder -result from large surgery. The cyst did not light up, it's not cancer. Nodule gone. No evidence of disease.
3/14/06	0	Chemotherapy Cycle 11	0	0
4/6/06	0	Chemotherapy Cycle 12	0	0
5/2/06	0	Minor Surgery to place central line for Stem Cell transplant	0	0
5/3/06	0	High dose chemo to prepare for Stem Cell	Fludarabine.	Immune Globulin-Gamunex to boost immune system.
5/05/06	0	0	0	Admitted to Bone Marrow Transplant unit to start Stem Cell transplant
5/7/06	0	High dose chemotherapy	Melphelan	0
5/9/06	0	Allogeneic stem cell transplant started. Received brothers stem cells.	0	Husband providing granulocytes to boost white blood counts.
6/3/06	0	0	0	Stem Cells grafting. The ymphoyd cells (ones that kill cancer) are 100% brothers. Myelo cells (takes care of bacteria and fungus) are 75% brothers.
6/7/06	0	0	0	Released from hospital.
6/15/06	CT	0	0	Clean. No evidence of disease.
6/30/06	0	Radiation	0	0
7/06	0	Radiation	0	0
8/06	0	Radiation	0	0
9/06	0	0	0	0
10/06	0	0	0	0
11/06	0	0	0	0
11/24/06	Six months study from transplant	0	0	Everything okay
12/1/06	CT	0	0	Some abnormalities spotted on brain and liver
12/11/06	Biopsy on brain	0	0	0
12/13/06	0	0	Relapse	2 large DSRCT lesions, several smaller lesions found on brain (9 in total)
1/07	0	CAM	0	0
2/07	0	CAM	0	0
3/07	CT	Consult about using 'cyber knife'	0	Slight growth in brain, 2 new lesions on liver
4/07	0	Gamma Knife used on 9 brain lesions. Chemotherapy.	0	Found a couple lesions on lungs. Chemo stopped for now.
5/07	0	0	0	0
6/07	0	0	0	0
7/27/07	0	0	0	Passed away

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