Lymphoma History Part 2

Since my bone marrow is clean and has no indication of cancer I can have an autologous stem cell transplant. This mean my own stem cells are harvested prior to high dose chemotherapy and transplanted back into me after high dose chemotherapy.

The other type of transplant is an allogeneic transplant which involves using donor cells and is a more arduous, lengthy and complicated process because of the risk of graft vs. host disease with the potential for war between the transplanted cells and the host cells.

After deciding to do an autologous stem cell transplant I had two cycles of a salvage chemotherapy with the acronym of RICE. I went into the hospital on October 20th (my birthday) for the first cycle of RICE and was in the hospital through October 23rd.

Upon admission to the hospital and prior to the RICE treatment a Central Venous Catheter was surgically installed in my chest and attached to a central vein (subclavian vein). The catheter is a Hickman triple lumen TriFusion catheter and provided three lines (access ports) for the taking of blood and the administration of chemotherapy. As bizzare as it is to have this catheter going through a hole on the right side of my chest, it's a lot better than getting stuck with IV's on a near daily basis.

This first RICE cycle was pretty miserable and when I left the hospital I felt pretty sick for a few days.

The second cycle of RICE was much better and for that cycle I went into the hospital on November 15th and returned home on November 18th. That cycle ended with the administration of Neupogen which stimulates the growth of white blood cells and the stem cells that were harvested for my stem cell transplant.

From the Non Hodgkin's Lymphoma Cyberfamily web site:

Give the donor a white blood growth factor called G-CSF which stands for Granulocyte Colony Stimulating Factor. The generic name for this drug is Filgrastim and the brand name is Neupogen. This drug encourages stem cells to mature very quickly into Neutrophils (a type of white blood cell). Because it causes such a rapid increase in neutrophils, the bone marrow is again forced to push the stem cells out of the marrow and into the blood to make room for all the new cells.

The plan was to collect the stem cells directly off of the RICE chemo.

On November, 25, the Friday after Thanksgiving, after 8 days of Neupogen (960 mcg of Neupoeng each day administered as two shots) my white count shot up and I went to the hospital (Presbyterian St. Luke's aka P/SL) for the harvesting of my stem cells. This is a process called apheresis and I spent approximately 4.5 hours hooked up to a machine that contains a centrifuge which separated out my stem cells from the rest of my blood. One line of my Central Venous Catheter supplied blood to the apheresis machine and another line of my Central Venous Catheter received my blood sans stem cells back from the apheresis machine.

The goal was to collect a minimum 2 million stem cells and usually this takes from two to five days. I was fortunate and 8 million stem cells were collected on that first day and I was done with apheresis. I did not have to go back to the hospital for further harvesting.

After a trip to New York during the second week of December to see family and friends I am ready to go into the hospital tomorrow, Thursday, December 15th to undergo six days of high dose chemo (with an acronym of BEAM) and the stem cell transplant.

More to come from the hospital.