Wednesday, November 11, 2009

The Stem Cell Transplant Schedule

Yesterday my case manager at Johns Hopkins sent me the schedule for the entire stem cell transplant procedure. This is still missing some of the times, but at least we know what is going to happen on what dates. Here is the run-down:

11/17/09 - 11/18/09
This is the evaluation phase. I will be poked and prodded and pushed around for two days, so that the team can decide whether or not my body will take the punishment, and to get "normal" baseline data for later comparisons.

This day is for training (e.g. we have to learn how to clean the catheter that I will get), and for the legal stuff (I will have to sign consent forms that hand over my life to Johns Hopkins).

The Hickman catheter will be installed. There is not much else scheduled, maybe because the procedure will be somewhat traumatic.

11/28/09 - 11/29/09
This is the beginning of the "mobilization" phase. I will get one of the drugs involved in chasing the stem cells out of the bone marrow and into the bloodstream. During the following week, which I will spend at home, I will be giving myself injections of another drug that is supposed to help this process.

This is where things begin to get tricky. I will be going to the cancer center each day, beginning today, to have my blood cell counts checked. When the team sees the right counts, they will connect me to an apheresis machine to collect the stem cells. In the event that not enough stem cells can be collected using this method, they will have to get more invasive, and get the stem cells directly from the bone marrow. I hope not.

12/14/09 - 12/15/09
Two days of high-dose chemotherapy. I will be getting melphalan dribbled in; when the process is complete, all of the cancer cells are supposed to be dead, and my bone marrow will be dead as well.

The stem cells extracted earlier wll be pumped back in.

And that's it. In the following weeks, I will be hanging around waiting for the stem cells to make their way back to the bone marrow and begin manufacturing blood cells again, meanwhile trying to dodge anything that would require the services of an immune system, which I won't have. I will be watched very carefully until my blood cell counts have returned to normal; meanwhile, if I do exhibit any symptoms of infection, I will be pumped up with whatever antibiotic or antiviral is deemed appropriate.

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