In July 2018, after 6 years of careful observation while my disease rested in an indolent state, the lymphoma kicked into gear and started growing rapidly. I experienced an abnormal increase in generalized lymphadenopathy (beyond the level I had come to get used to as normal), and a CT revealed thoracic and axial lymph nodes which were significantly larger than typical. A PET CT revealed high metabolic activity in many chains of lymph nodes, indicating the disease had shifted in its behavior from indolent to aggressive.
On one hand it’s disappointing that the disease began progressing. On the other, it’s now in a state where it is more likely to respond to treatment. In August 2018 the decision was made to begin interventional treatment: chemotherapy to attack the actively-growing lymphoma, followed by an autologous stem cell transplant (treatment which includes very high doses of chemotherapy, total-body radiation, and a type of bone marrow transplant where I am both the donor and recipient) which may help prevent its recurrence in the future.