Day 1046 - Mutated Mutation

Hi world. I'm back with more feelings.

I need to give a little background about my project in the lab to put this into context. Like I said in my last post, I work with patient samples of AML. Before I started doing real experiments, I was just screening the 20-30 samples we have to see if they have a mutation in the RUNX1 gene. We're working with this gene because it's associated with a poor prognosis, so finding a way to effectively treat these patients would be wonderful.

One of the samples I've been working with belonged to a patient that my PI knew personally...and I say "knew" because that patient died. The AML was really aggressive, as showcased by the fact that if you inject those cells into mice, they all get leukemia. Nasty, nasty stuff.

Anyway, I've been having trouble getting a good read on whether or not this sample has a RUNX1 mutation. My PI and I were talking about it today, and he said, "Well, I wouldn't spend too much time on it. [Patient]'s cells were NPM1-mutated, and those are almost never seen with RUNX1, so I highly doubt you'll find a RUNX1 mutation in that exon."

Allow me to refer you all back to Day 13 - Jailbreak, when I first received the results of my cytogenetic testing. My leukemia cells had an NPM1 mutation. I was informed that this was associated with a good prognosis and that my cells would likely be more susceptible to chemotherapy, and this is why NPM1 and RUNX1 are almost never seen together.

Then why, for the love of God, did this patient die? NPM1 is supposed to put you in a low-risk category, yet here we have this person's crazy-ass cells that express weird adhesion proteins and make a lot of mice really unhappy.

At first, it wasn't clear to me why this bothered me so much. I'm not necessarily scared of relapsing; the scientist/logical person inside of me understands that no two cases of cancer are exactly the same, and I know that going into remission after only three rounds of chemo when my bone marrow started out at 91% cancer cells is pretty damn good.

No, this isn't fear. This is survivor's guilt at its finest. It's hard enough for me to deal with people dying of cancer in general, and it's even worse when it's leukemia. But to have the SAME mutation as me? It's not fair. That person should have responded to chemo and been completely fine, just like me. Did this person feel a sense of relief when they found out they had that mutation? Only for this to happen? Ugh. Being a cancer survivor should make me feel proud and empowered, but in situations like this, it mostly makes me hate myself.

Aside from my crippling guilt, a crazy thing to think about is how this person's NPM1-mutated cells ended up in the hands of a girl who also had NPM1-mutated leukemia. Maybe this person would be glad to know that their cells are being studied by someone who thoroughly understands and empathizes with what they went through. I guess that's why I do what I do, right?

Meh. I'll keep telling myself that.