Monday, October 13, 2008

The Basics of a Bone Marrow Transplant

Totally out of my league here. So I will begin by quoting from "Preparing for Transplant" by Seattle Cancer Care Alliance.

"The purpose of transplant is to cure otherwise fatal diseases using high doses of chemotherapy, irradiation, or both. Because of the intensity of this treatment, your body is not able to make blood cells. Your ability to make blood cells is restored by giving you stem cells. Healthy stem cells are given to you, that is, transplanted into your body. The stem cells grow and restore your body's ability to make blood cells.

Stem cells are very young cells which mature and develop into red blood cells, white blood cells, and plateletes. Red cells (erythrocytes) carry oxygen to other cells in your body. White blood cells (leukocytes) fight infection. And plateletes (thrombocytes) help your blood to clot. All of these cells develop from stem cells.

Stem cells are produced in your bone marrow. It takes several weeks for the stem cells to regrow (engraft)in your bone marrow space, and eventually produce red blood cells, white cells, and platelets. During this time you are susceptible to several complications and will need close monitoring.

In an allogenic transplant, you receive stem cells from a family donor or an unrelated donor. The donor chosen has a tissue type which matches your tissue type as closely as possible."

The process has been explained to me as essentially having three steps: conditioning, transplant, and engrafting.

Conditioning includes high dose chemotherapy and total body irradiation. This step destroys the body's cells and marrow, basically emptying you to be ready to receive the transplanted cells. During my consultation, this was explained to take around seven to ten days.

The actual transplant doesn't seem to be a big deal. The new cells enter the body through a bag that looks alot like a transfusion bag.

It's the next 100 days that's the huge deal. Approximately 10-28 days post-transplant, signs that new bone marrow or stem cells are growing and beginning to make new blood cells are expected. This means that engraftment is taking place. After that, it's watch and wait, and hoping that all the icky stuff that can happen, doesn't, and all the things that can go wrong, don't.

All in all, the transplant requires an average of four months in Seattle. And alot of ickinesss.

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