Allo~Transplant Lesson 101-103...or so

First let me say, I feel so much better…so all that worry is GONE! The hospital visit was actually good for me. They were able to pump me with strong antibiotics, blood, and other stuff. My mouth, throat and stomach are pretty much healed…and I can swallow again! My meds are cut down, but I am taking steroids (looking forward to the “moon face”) now to keep the GVHD syndrome (I’ll explain that later) under control.

Second, the question; “stem cell” transplant verse “bone marrow” transplant.? It does sound confusing but simply put, they are one in the same. I have copied some technical info from a site that might explain it better.

“A stem cell transplant is a medical procedure in which diseased bone marrow is replaced by highly specialized cells, called hematopoietic stem cells. Hematopoietic stem cells are found both in the bloodstream and in the bone marrow. Today, this procedure is more commonly called a stem cell transplant, rather than bone marrow transplant, because blood stem cells are typically what are being transplanted, not the actual bone marrow tissue.”

Now, a little more…last summer I did an “auto” (my on stem cells)…didn’t work for me. So this time I did an “allo”…donor cells, a little more risky. Here is some more technical jargon. It also gets into the GVHD question.

“In an ALLO transplant, another major risk is that the donor’s cells will recognize the patient’s body as foreign, causing graft-versus-host disease (GVHD). GVHD may be a serious complication of allogeneic transplants and can be fatal. Other side effects may include liver problems, diarrhea, infections, and rashes. However, GVHD can also be a benefit, in that the donor cells can recognize the cancer cells as foreign and destroy these cells, a mechanism that is one of the major reasons why ALLO transplantation generally works so well over the long term. The risk of GVHD can be reduced with exact HLA-type matching and the use of preventive drugs.”

Now don’t get all excited about the “fatal” word…they have to tell you that because it is true, but that is NOT the road for me. As you can read in the last sentence, HLA-type matching and preventive drugs are great help…and we all know my sister, Linda Joan, is a “10” the highest match available! Not to mention, the blessings given over those aggressive little suckers! You can see it my counts. The next question.

I have attached a summary of my labs.

	Day +1	Day +2	Day +3	Day +4	Day +5	Day +6	Day +7	Day +8	Day +9	Day +10	Day +11	Day +12	Day +13	Day +14
LAB Date	24-Mar	25-Mar	26-Mar	27-Mar	28-Mar	29-Mar	30-Mar	31-Mar	1-Apr	2-Apr	3-Apr	4-Apr	5-Apr	6-Apr
WBC	2.4	1.3	1	1.1	1	0.6	0.4	0.2	0.2	0.2		0.7	0.7	1.1
RBC	3.33	3.48	3.35	3.59	3.45	3.41	3.47	3.16	3.13	3.1		2.71	2.71	3.55
HGB	10.3	10.7	10.5	11.2	10.6	10.06	10.7	10.2	9.7	9.5		8.5	8.5	10.6
PLT	50	49	45	43	29	22	17	9	52	42		37	37	63
												*
ALBUMIN	3.5	*	3.5	*	*	3.5	*	*	*	3.5	*	2.7	*	*
	Day +15	Day +16	Day +17	Day +18	Day +19	Day +19	Day +20	Day +21	Day +22	Day +23	Day +25	Day +26	Day +27	Day +28
LAB Date	7-Apr	8-Apr	9-Apr	10-Apr	11-Apr	12-Apr	13-Apr	14-Apr	15-Apr	16-Apr	17-Apr	18-Apr	19-Apr	20-Apr
WBC	1	2.2	2.5
RBC	4	4.29	4.29
HGB	12	12.6	12.9
PLT	110	188	193
ALBUMIN	3.2		*

It talks about WBC (white blood cells, fight infections), RBC (red that take oxygen out to the body), and PLT (platelets that clot your blood), and some other stuff…but those are the 3 most important cells. Those of you who can’t, basically it tracks my stuff showing the fall of my immune system after the chemo and transplant to nothing. That is why I cannot be around or go any where, and why they rush you to the hospital at any little show of infection. The miracle is that it takes about 14 day for stems cells to start to grow. My labs started an up turn on the 14^th day! Thank you Lord, Amen! And they are continuing to go up. My platelets are already well within the normal range, at 193. I only made it to 147 from my last transplant; bottom of the range is 150. Amen! So I have 2 of the 3, just waiting on the WBC presently at 2.5, but WILL continue to get to normal (4.5-10.5).

So what is this rash from? Well it is not GVHD (yet). It is called GVHD syndrome. Big difference; the difference being it is NOT the disease, it is my new cells (sister’s) sending a warning out to my body…”something is not right, but not sure yet.” In other words, the new cells are waking up, and realizing that they are not in a familiar place. This is a good thing! This means the cells are working, now lets just keep praying that my old cells aren’t going to be mean to “big” sister. The treatment is steroids and Prograph (immune system suppression) for now. For how long, don’t know…from this point it is a wait and watch.

GVHD = Graft (LJ cells), Verses, Host (me), Disease

I am in a very happy place right today and going to enjoy it. So please go there with me! The road is still very long, and full of lots of “pot holes,” but I know God is with me and he has purpose for me, I can do this. Going to the clinic really keeps me grounded. I see so many others that are really struggling and I pray for them, who knows that just might be my purpose!...but I don’t need to know. I just need to stay strong in my faith, but most of all become “fearless,” and I gotta tell you…it is hard! But today, my dear friend Barbara sent me a sweet devotional: When I am afraid, I will trust in you (Psalm 56:3) Prayer: Lord, help me to live free from fear as I fully place my trust in You. God is good, sending me this short, simply but oh so direct for me today! Amen.

Also from the clinic, I realize I am so blessed with extensive family and friend support. It is overwhelming to me. It is so heartwarming! Here is a happy photo that I forgot to attach on Easter. Pam came by Easter morning bringing Easter “happys” wearing Mrs. Berry’s hat…and brought and extra one. AJ insisted we wear them to the clinic. What a man my man is! I love him so.