Most people are at least familiar with the idea of a bone marrow transplant. Well, a stem cell transplant is something similar, and is a follow-up to the decimation of the blood cell producing bone marrow after high and extended doses of chemo therapeutics.
The actual "harvest" is done through a pheresis procedure, where blood is removed from the body, put through a centrifuge, the stem cells removed and the remaining blood reintroduced into the body. We've not been through this yet (obviously) but it sounds a lot like dialysis to me.
Once harvested, the stem cells are frozen and stored, for future use.
In order to get enough stem cells to do a transplant, we have to artificially increase the body's production of these cells through the use of a stimulating growth product called Neupogen. Neupogen is given as a subcutaneous injection and is basically the absolute worst part (in Harper's opinion) of the entire therapy.
We've given her a dose of 5mg/kg for the past 5 days and will give her another dose tonight. With so much stimulation, the excess stem cells basically overflow into the bloodstream, where they will be picked up by the harvest.
Another fun part of this little exercise is the insertion of the additional large catheter through which the blood will flow for this harvest. Her broviac central line is apparently not big enough, so today, under general anesthesia at Kosair, they inserted a temporary catheter in her neck. Not a pretty sight.
This catheter will stay in until the harvest is complete. Fortunately, the catheter can be removed at "bedside" which means no surgery to remove. Unfortunately that means she will be awake. Not really looking forward to that...
She was a real trooper, though, for the insertion. So, perhaps we'll be surprised. At least now she seems a little more used to the sight of blood than she was when we started, but I'm guessing the idea of them working on her NECK while awake, and the fear of associated pain, will make for an interesting removal.
All of this for something we HOPE we don't need. See, the stem cell transplant is not in her current treatment plan. But, if she doesn't respond to the standard chemo (all signs so far are that she is) or she has a relapse (after treatment is complete and she's listed as No Evidence of Disease (NED - which will be a VERY good day, indeed)) then they can escalate the treatment to the high dose chemo with stem cell rescue.
And we hope we never get there. We hope the current chemo, with surgical removal of her kidney, and potentially some radiation, will do it, and she'll be clear. We hope the stem cells sit in the Kosair freezer and are someday discarded.
We're going to bring in the crops tomorrow, but we hope this harvest goes completely to waste.
No comments:
Post a Comment