Transplant (Part 11)

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"You do realise there could be up to a 30% chance of dying during the transplant process. This means for every 100 patients treated in this way, up to 30 could die."

Initially my brain screamed at the consultant that I was fully aware of the percentage concept. Then, as I suppose the doctor intended, that figure transformed into real people, who really could die, in real life.

I always hoped I would be able to avoid a bone marrow transplant, or stem cell transplant as they are now called, and just carry on with the cycles of chemotherapy. But this wasn't to be.

Following my second cycle of chemotherapy my bone marrow, under the microscope, looked great. Good enough for the Acute Myeloid Leukaemia (AML) to be classed as being in remission.

Genetically, however, things were not quite so hunky-dory. Again my bone marrow had been sent away for further tests and the results were not good.

The abnormal cells associated with my secondary, chronic form of leukaemia, had increased from 20% to 50%, between the two sets of chemotherapy. Not only that, but they were becoming increasingly bizarre at a genetic level.

At this stage the crucial factor is whether a donor is available. Thankfully I have a common tissue type and a donor was identified quite quickly. This was vital because the results suggested that the chronic form was aggressive and the fear was it could trigger another outbreak of AML.

The Anthony Nolan Trust searched the European databases and found a match for me.

At the moment if you are white, and have a common tissue type, you are quite likely to find a match.

However, it can be much harder for ethnic minorities. My plea in this blog is that all readers, if they are not already, should consider becoming a donor. Please have a look at the Anthony Nolan site via the link.

Many more Asian, black, and mixed-race, donors need to be found in order to prevent more lives being lost to leukaemia and other cancers of the blood.

There is also a lack of males on the register too.

The next post will contain more information about what it's like to donate stem cells.

So, the transplant itself.

Firstly the good news is it can be a lasting cure for leukaemia. The odds of being cured are also better than chemotherapy alone.

It also represents great hope. I don't know how much longer I would have lasted without it, but it probably wouldn't have been for much more than a year.

If you could just pop the new stem cells in with no side effects it would be fantastic. But, as you probably can imagine, it's not as simple as that.

For your body to accept the foreign cells you need to be exposed to even higher levels of chemotherapy and intense radiotherapy. This clears your bone marrow in preparation for the new stem cells to bed in.

Exposure to these greatly increases your chances of getting further cancers later in life.

There can also be problems if a conflict develops between the 'host's' body and the donor's cells. This is known as graft versus host disease, if this is severe it can also lead to death.

However, the best chance of being cured is if conflict develops between the new cells and the leukaemia. This is known as graft versus leukaemia and is highly desirable.

Throughout the process your immune system is entirely wiped out until the new stem cells begin rebuilding it. Because of this there is a huge infection risk.

In summary, the downsides are:

Up to a 30% chance of dying.

A lowered life expectancy because you are far more likely to develop secondary cancers.

Infertility.

You need your vaccinations again because it's like growing an immune

system from scratch.

If it goes well, you will have to be in isolation for four to five weeks.

This is all on top of the usual vomiting and hair loss.

I should also add my blood group will change from O+ to A+ - that of the donor's - after about six weeks.

Before I spoke to the doctors about the transplant, I always thought I would have to undergo some sort of operation. This is not correct.

The donor's cells are given just like a blood transfusion. Once in the blood stream the new cells just know where to go, which I have to say, is pretty bloody amazing.

Before my transplant began I had the strangest mixture of emotions; hope, enormous gratitude, apprehension, resentment that I had to go through it yet feeling incredibly lucky that there was a donor.

When a doctor reads out the following list of possible side effects in a dead pan voice, "nausea, severe infection, death," you know you're up against something serious. But I also know there are thousands of patients who have not only survived the procedure, but gone on to live full and

healthy lives.

That was always a great source of strength for me.

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4 Comments

Ad,

First off I'd like to say I always thought you were common!! Just so you know, the National Blood Service also have a stem cell register and, when I contacted the Anthony Nolan Trust, I was told NOT to register with both lists (I'm on the NBS list as they can take a sample of blood for tissue typing when you give blood).

Secondly, as you're probably aware by now I am a complete genetics nerd! I was wondering if you know what genetic abnormalities you have?

Good luck with your transplant and I'll be thinking of you!

Love as always

Tom

Adrian

Good to have you back. I am amazed at how much knowledeg you have packed in in such a short time I have been at this daily since July last year and still stuggle. I do not wish to take up your blog with Phil's condition but if you want any information or we can reassure you in any way, we searched for someone to give us personal insight throughout the transplant, mail me direct you must have my address. Meanwhile Phil is on day 103 today and picking up really well, don't get despondant you are young and can do this.

Trish

Hi great to read your blog. You might like to visit www.thetxspace.com

Hi i have just being think and i have being a bit selfish lately and i shoudnt be because i am very lucky.life is painfully to short i am 11ys old and have being studing about this blog at school.

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About this Entry

This page contains a single entry by Adrian Sudbury published on May 2, 2007 12:00 PM.

Pneumonia (Part 10) was the previous entry in this blog.

Bone marrow donation - it should be called stem cell donation really (Part 12) is the next entry in this blog.

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