Page 172 of Missed Notes (Rixon High 5)

Sofia

“It’s notthe news I’d hoped for,” Dr. Jeffries said.

He’d come into the room a minute earlier wearing a grim expression, one that had plunked a heavy stone in my stomach.

“Okay, what are we dealing with?” Dad asked while Cole and Mom gripped one of my hands each.

I’d asked him to be here for this. Not only for me, but for Aaron too.

Mom and Dad had urged me to reconsider but the second Cole realized what we were discussing, he insisted he wanted to be here too.

“Sofia’s blood work indicates that the disease has moved into what we call the accelerated phase. This means the targeted therapy we’d hoped to start her on next week may not be as effective.”

“So what are our options?” Dad ran a hand down his face, all business.

“We can go ahead with the TKI treatment and hope it works. Or we can try and match a donor for stem cell transplant. Sofia is a good candidate for the procedure, but it does carry its own risks and side effects.

“We’d have to give her a high dose of chemotherapy to get the cancer under control and prepare the body to receive the donor stem cells.”

“Could it cure the CML?” Aaron asked.

“It could. But as with any of this, there are no hard and fast rules.”

“What would you recommend, Doc?”

“Given the rate at which the disease is accelerating we may lose precious time if Sofia doesn’t respond to the TKI therapy. But a stem cell transplant is a huge undertaking.” He looked at me. “We’re talking two weeks of conditioning treatment. You’ll have to stay in the hospital with restricted visitation as once you start chemotherapy, you’ll be susceptible to infection. After the transplant, it will be at least another month in the hospital while your body grows the new cells, and your immune system strengthens.

“You’ll need daily observations, blood work, and other tests to make sure everything is going smoothly. The side effects can be quite unpleasant. Infection, bruising and bleeding, nausea, diarrhea, hair loss, breathing difficulties,” he went on and on.

Jesus.

Cole squeezed my hand, and I lifted my eyes to his. He looked as devastated as I felt. But the transplant offered me a chance at being cured. Not long-term disease management—a cure.

“Once your blood counts reach a safe level, we can talk about sending you home. But the strict monitoring regime will continue. Weekly appointments at the hospital, limiting socialization, being extra vigilant with hygiene and infection control. After a year post-transplant, your immune system should be working well. Sometimes, it can take longer.”

“A year,” Mom murmured.

“That’s a realistic timeframe. But every patient is different. Complications and side effects can arise and hinder progress at any step along the way.”

She nodded, her face pale.

I felt sick. Completely and utterly out of my depth.

“How fast do we need to make a decision?” Dad asked.

“The sooner, the better. Finding a donor match can take time. There’s just you and your brother, correct?”

Aaron and I both nodded.

“He should be tested as soon as possible. One in four siblings are a perfect match for allogenic transplants.”

“I’ll do it,” Aaron said without hesitation.

“Good. We can get that organized. If you’re not a match, we can widen the net.”

God, this was happening.

It was really happening.

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