The science behind a stem cell transplant is elegant in its simplicity. Blood stem cells, which reside in the marrow, are mobilized by medication to move into the bloodstream. Once they are present there in sufficient numbers, the patient is hooked up to an apheresis machine that separates and collects the stem cells. These cells are cryopreserved (frozen) until needed.
The patient then receives high-dose chemotherapy. The intent is to deliver a dose that obliterates the marrow function and results in the greatest possibility of destroying the disease. In a day or two, when the drug is metabolized, the patient’s stem cells are thawed and returned to the bloodstream. These stem cells then migrate to the marrow and rebuild that environment.
If you use stem cells from your own body, the procedure is relatively safe. In fact, the transplant can be done as an outpatient. However, without the protection of a fully functioning blood system, the patient is vulnerable to life threatening infections. Accordingly, close monitoring while the stem cells engraft is necessary. It is recommended the patient stay within 15 minutes of the clinic conducting the transplant.
Also, it is essential that they have a caregiver at their side for the duration of the procedure. The high dose chemo can discombobulate the patient for a period of time. So, someone needs to keep a watch and make sure medicine is taken as prescribed, appointments are met, and complications are attended to immediately. Once the counts of blood cells reach certain levels, the patient can be allowed to return home to the care of their referring physician.
All of this takes time. The entire transplant process may take two to four months. Furthermore, the patient’s immune system will be suppressed for up to a year following the transplant. Participation in normal social activities must be curtailed. It may be six months or longer before one can safely return to work.
Since my wife, Marilyn, will be my caregiver it is necessary that we both take a leave of absence from our jobs. We are prepared to be away from Hood River for the summer. We have a strong support group of family and friends that have helped us with the many issues caused by our being gone.
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