Bone Marrow Transplanting

The first thing I learned, is that there is no real need any longer to go into the actual bone and marrow, to get what is needed for a bone marrow transplant. In the case of my dad, they need to get good cells, stem cells, etc to transplant back into him after his immune system is going to be brought down to zero. It is a rescue effort to bring back good blood cells.

The process uses a triple line catheter, and centrifuge during the collection process. Before this happens, they inject something that stimulates the growth of the right cells inside the bone marrow. This in turn ends up in the blood stream, and can be taken from there. The bones can experience some pain during this time, but it can be helped with pain medication. There can be pain in the legs and hips mostly, but sometimes bone pain in the arms and sternum are also mentioned.

My Dad's process will be autologous, which just means he is donating to himself, and is receiving his own cells. During the process of collection, there is a centrifuge, which does some kind of spinning of the blood and can determine the correct molecular weight which indicates it is the desired stem cells. They can then separate these cells out from the rest, while putting the rest of the blood right back into the patient! Its an amazing process. Please forgive my "layman's terminology" as this is all new to me. They will collect up to 15 liters per day, for approx 4-6 hours (long estimations) for up to 4 days. They will continually check all things in regards to the blood during this time. This will occur after very strong doses of chemotherapy have been administered, then a rest time of two days, for the chemo to be eliminated by the body.

They are going after special stem cells, pluripotent stem cells, aka mother cells which can regenerate all kinds of needed blood cells when put back into the patient later. They will be put into 70 ml bags and will be using a cryopreservative, DMSO, which keeps cells intact. They will then be put into a control rate freezer, then immersed in liquid nitrogen and kept at -197 degrees. To bring back to an unfrozen state later, they are put into a 37 degree water bath to thaw. Once thawed, it cannot be refrozen, so they treat it very carefully and store in small portions. The patient will become neutrapenic at some point, and this is a somewhat dangerous stage, but they can control it well and keep a close eye on things. White blood cells only live for 6-10 hours, something I didn't know before. So its difficult to collect from donors even then give to patients that need, for the sheer time span involved.

There are 3 types of blood cells, white, red, and platelets, but what I didn't know is that there are 5 or 6 different white blood cells in our bodies. The white blood cells will be to zero for a few days. During this time, the patient is in a very clean but not isolated completely. They are encouraged to keep all dust to absolute minimum, as well as not eating ice cream from a soft serve machine (including shakes), and not having cold deli meats. The problems that can occur with those things can be handled by the average person just fine, but can be deadly for patients in a zero white blood cell condition.

Once transplanted back into the blood stream, the precious cells somehow make their way back INTO the bone marrow, then root there, and begin the process of creating the new blood cells. They still don't know exactly how it happens, they just know it does happen. It may happen in an opposite way the blood cells are made then come out of the bone marrow. The biggest concern is with 2 of the types of white blood cells that do the most "fighting" for your body.

In my dad's case, they are taking precautions to make all efforts to keep ANY cancerous lymphomas from returning and creating new brain tumors. At the moment, he is completely free from any observable cancers or tumors,which prior to the other chemotherapy, was life threatening to him. This doesn't mean there aren't any very tiny undetectable "things" that could later turn into tumors again.

Best news of all, is that this isn't one of the hardest things you can go through and that they have great success when they do these transplants. I am excited and nervous both, and very thankful for the health I have and that of my family. I am thankful to God and the breakthroughs in science and technology and for the doctors that make any of it possible at all.