I’ve had a couple of questions over the past week regarding the procedure of Transplant – the chemo, other drugs and the Transplant itself – so I figured I’ll give you some general information about what will be happening and why, with my Patient knowledge, it should be easy to understand for most everyone.
To start I’ll address my diagnosis which came on Friday July 20th, when my Doc analyzed my bone marrow sample and found there to be over 50% Leukemia blasts in my blood, which means to me that it was very prominent. My blood counts had started to drop by this point but they were pretty healthy compared to the first time I was diagnosed, November 1998. The following Monday I started chemo – this meeting with Mo was the same as my first meeting with him, back when I called it Game 1. By the same I mean I had the same combination of the same two drugs. Mo and Push Mo.
That first round of Mo is called “induction” chemotherapy as it is designed to induce Remission. The term Remission suggests that there are less than 1 Billion (with a B) diseased cells in my body and that term can apply for any disease. Fortunately after induction Mo we reached that magical place on this journey called Remission, but the Docs know that if I don’t have additional treatment that my Remission status won’t last long. So that is where the Transplant option comes in.
Most of you will remember my decision process between having a second Transplant and the experimental DLI procedure. Ultimately I did decide to have a Transplant and that is why I’m here in Ottawa. My first Transplant I had what is traditionally called a Bone Marrow Transplant, and that involved taking actual bone marrow from my Dad, who was and is my donour, and giving me his marrow. This time I’ll have what’s called an Allogeneic Stem Cell Transplant, which means the Docs will only take my Dad’s stem cells from him. Stem cells are the core of bone marrow as I understand it and thus they are the ‘guts’ of our blood factory.
First time out my Dad had general surgery to remove his marrow, this time the process will be far less involved for him. He takes a drug called GCSF which I have taken many times as the drug is designed to help your blood counts recover, and in healthy Patient’s it actually brings the stem cells out into the blood stream. From there my Dad will have blood taken from one arm, run through a machine designed to remove just the stem cells and have the rest of his blood put back in the other arm. So he’ll be hooked up on both sides for somewhere around 3 hours at a time for somewhere around 5 sessions depending on how plentiful his stem cells are.
What that means?
First time out I received 1.2 liters of Dad’s marrow, this time I’ll probably only receive about 100 ml as I’ll just get the stem cells and no other part of his blood. We do have the same blood type, but the interesting note for the day is that the Patient’s blood type if different from the Donours will change to be the same as the Donours after Transplant. Interesting hey! But before I can get my Dad’s stem cells we have to make room for it, and that is why I’m having chemo now. The drugs I’m on now and the higher dose stuff I’ll get on Sunday and Monday are designed to clean me out, clear out my marrow so that I have no immune-system and then send my Dad’s healthy cells inside me to set up shop and start making healthy blood again.
There are benefits of having just the stem cells as opposed to the bone marrow. Studies have shown that Patient’s blood counts return on average near 2 weeks earlier than with traditional bone marrow, which makes sense if you think that I’ll be getting a higher concentration of the “good” stuff with less interference. The other benefit is that Stem Cell Transplants have proven to induce more Graft vs. Host Disease, which is the disease the develops inside me from the “graft”, my Dad’s stem cells, taking hold inside me the “host”. GVHD, as it is called, is important to have, but as with everything in life there is a balance. Too much can kill you, not enough often results in unsuccessful Transplants.
That’s the technical stuff for today, you will probably hear me refer to my Transplant as either a bone marrow or stem cell, they are often used inter-changeably. All else is well, had a MUGA scan done today which is a heart scan. The second easiest test I’ve ever had done, two needles of liquid, one radio-active, and then I lay on a table for about 25 minutes while the camera took pictures of my heart between beats – about 1,500 pictures that will be made into a movie to see how my heart is functioning. Tomorrow morning I have my pulmonary function tests to see how my lungs are and then I may even get a break from the hospital on Saturday as my counts haven’t started to drop yet and I’m still feeling well.
Hope you are great and I’ll be back again soon.
Always…
Live Life. Love Life.
Geoff
