January 16th was the first
time I heard the words “stem cell transplant”. Soon I was so familiar with the
term I was explaining it, with little diagrams included, to my children, my
siblings and my mother. At this early stage it was unclear whether I would have
an autologous transplant, meaning I would donate my own stem cells back to my body,
or an allogeneic transplant which meant I needed donor cells. There was plenty
of time to decide; the transplant would be months away.
With
an autologous transplant first they had to “harvest” my stem cells. This
brought up all sorts of farm images. I visualized the process with the
following analogy: A growth hormone would encourage my stem cells to reproduce,
like adding fertilizer to a field of corn. Then they would gather the stem
cells (the corn kernels) and freeze them. The next step would be destroying the
rest of the cells in my bone marrow with high dose chemotherapy, like burning
the field after the corn is picked. When the bone marrow was ready the frozen
stem cells (kernels) would be re-planted. The catch was killing off all my
cells would also mean destroying the infection-fighting white blood cells
called neutrophils. So it would be like re-planting without having any insect
spray.
Farm
analogies aside, the transplant could potentially make me very sick. There was
the risk of serious infection. But at the time the gruesome details didn’t
bother me. I was infinitely more entranced with the idea that there might be a
way out of the mess I was in with a life-saving treatment. I was also thrilled
that my doctor thought I qualified as a life worth saving. He had faith that I
could make it through. It was like I had just been given a golden ticket after
auditioning for American Idol.
In
January I was asked to contact my siblings in America to get tissue typed for
an allogeneic transplant as siblings are the best chance for a stem cell match.
By March it was determined that I would have an autologous transplant instead.
Like many things about my treatment, I didn’t know why there was the
turnaround. I knew there were much higher risks associated with the allogeneic
transplant. Side effects like graft-versus-host
disease (where lymphocytes from the donor attacked cells in the recipient)
could cause skin rashes, jaundice, liver disease, and diarrhoea. But I thought my case was desperate. I
also had read that an allogeneic transplant is the only real chance for a cure
as the stem cells would be “clean”. With an autologous transplant I would be
getting my own, potentially cancer causing stem cells back. But I trusted Dr
Comfort and didn’t question the change of heart.
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