Waiting to be Randomized

I have opted into a Research Study.

I will be randomly placed in one of two groups

 The RIC and The HIC - Reduced Intensity or High Intensity Chemo.

It is presented as a coin toss, but the coin-tosser in this case is a computer at NIH.

It is way more than a coin toss, which I had sort of sensed and remembered from a statistics and probability  chapter in some college textbook. Double Blinds and Placebo Effects, and stuff like that. While looking for a cartoon of a coin tosser to post, I found this site, Statistically Funny written and illustrated by Hilda Bastian, who granted me permission to link to her blog.  I look forward to getting to know her, as I have no Epidemiologists in my address book, much less ones who are globetrotting lecturers on the arcana of epidemiology, and have a great sense of humor.

A sample of Hilda's work

More over the fold - click to jump





Soundtrack ( Johnny Mathis )

The trial

A Randomized, Multi-Center, Phase III Study of Allogeneic Stem Cell Transplantation Comparing Regimen Intensity in Patients with Myelodysplastic Syndrome or Acute Myeloid Leukemia

The test compares two strengths or intensities of the chemo pre-treatment.

One group gets the reduced dose, or RIC, the other the HIC or High Intensity dose.

I will randomly be assigned to one of these groups.

Why,  you may ask , would I volunteer to maybe get the  High Intensity Chemo Treatment? Latent masochism?  Like hitting my thumb with a hammer because "it feels so good when I stop? ,

It did not take me long to make my decision.

 Also Sprach Ramona   "Chemo is my friend." , and  she really nailed it. 

Thus Spoke Ramona, my new-found biological daughter in law, who has just started treatment in Germany, and a blog about her cancer. Here is her post on countdown-to-treatment.   Her blog is http://nobodyscancer.blogspot.com/.  Not your usual cancer blog.  Fresh, healthy approach. 

Subscribe, or at least  forward to those folks in your circle who have cancer.

Chemo is  just a part of what is going to kill off my mutated stem cells.  The Mutants that survive the chemo should be recognized by my new stem cells as cancer cells, and destroyed by my immune system.

Chemo is as much my friend as my Saintly Sib Donor's marrow.

I look at it this way:

* If there was no trial, I would probably get the standard High Intensity Dose or something close to it, and have the side effects.  

* If I get the RIC, then maybe the chemo does not wipe out all the mutants. That just means more work for my new immune system. But since I am a 10/10 match with my Sib donor, the chances are ( there's that epidemiology again ) that it will be strong in battle.

* Either way, I feel it is my moral and civic duty to participate in the test. If in 10 years the results demonstrate that either No, you don't need to use so much chemo, or Yeah, you better put the poison to -em, in fact step up the dose! -  that needs to be known.

We used to have a saying, "Random Events only Appear Random"

Depending on your cosmology and theology, this can mean a variety of things. but it boils down to the sense of being caught up in, and guided by events beyond your control. Now you can either hang on for the ride, or opt out. By choosing to participate I am hanging on for the ride, and if that means the extra-strength chemo then so be it. From random genetic mutation of  my #9 chromosome,  9qdel, to the computer generated random coin -toss. I am on board.  Heads or tails, it beats the accelerated demise caused by MDS, living in a self-imposed quarantine as a  neupie, getting more frequent transfusions and stimulants until my refinery output no longer could support life.

For those of you who need a stronger " Geek Fix"  there is more info about the sophisticated coin toss done by the National Institute of Health here Understanding Clinical Trials


Back in 1950 and there were Reds in California, and fears of dietary induced heart trouble. Amazing.


plus ça change...

plus c'est la même chose

Results of the toss, and more to come,


Chris

EDIT:  Got this from the medicos this afternoon   

"I know we will be seeing you in a couple hours, but wanted to give you heads-up that the Randomization is complete.  You will be receiving myeloablative chemotherapy, not the reduced intensity."

So there it is. Random events only appear random. 

Starts tomorrow.