I HAD A LYMPHOMA /25

HIGH DOSE CHEMOTHERAPY AND STEM CELL TRANSPLANT

BACKGROUND AND OPTIONS.

Being now in full remission from my T-cell Lymphoma {Non-Hodgkin"s disease}. and having had my fourth and final INTRATHECAL Lumbar Puncture last Thursday, and being in the middle of the side effects from that, I have decided, nevertheless to report initially into what I have discovered about the now proposed, High Dose/Stem Cell Transplantt treatment proposed to me and in respect of which, a Consultation was booked for this coming Thursday. Now, however, due to no Consultant being available this has been put back a week to February 10th. That suits me fine for by then the lethargy induced by the INTRATHECAL will, on previous evidence, have subsided by then. A 1 unit Blood Transfusion last Friday has made no discernible benefit to this feeling of low energy and inducing of daytime napping. It seems that the usual 6/8 days will need to pass as before to see energy begin to return again.

The planned Consultation in London will determine if they will take me as a suitable patient and if so, then I must decide whether to accept given both Benefits and risks involved.As explained previously, the transplant can either kill completely and cure the disease or increase the time of control of it. There is no complete guarantee and it will be interesting to see what percentage the Consultant gives on my type of Cancer. The risk potential is lower where your own stem cells are used{autologous transplants} and this is proposed for me.Any transplant, including those from donors ,may or may not be successful in seeking to deal with the potential return of the disease.As I have been told already, there is also a mortality risk, described as "small" but again something to discuss more at the Consultancy meeting.

The procedure involves taking out bone marrow which contains the stem cells and store them in a frozen situation. The high dose Chemo is then given which destroys the cells in the bone marrow. The stem cells are then used to recover from this intensive treatment and initiate the production of healthy blood cells to enable the bone marrow to recover and function normally and produce new cells.

STEM CELL COLLECTION AND STORAGE

Essentially there are 2 methods of collection of Stem Cells. 1. Bone Marrow Harvesting {BMH}.2.Peripheral Blood Stem Cell {PBSC}. both require general infection testing including blood tests for previous viruses-{I caught viral Hepatitis over 30 years ago}. These have to be completed before any treatment is commenced to ensure no cross infection can obtain when the Cells are frozen, or as technically termed, cryopreserved.The exact nature of the stages of the collection and storage procedures are best left to explain here when I have the methods to be used on me as explained by the Consultant at our meeting, but as implied contain the passing of Chemo high dose drugs through the veins and ultimately collection of the cells via a Cell-Separator Machine which takes in blood from the body, passes it round a high speed centrifuge and then bags the stem cells and returns the remaining blood cells to the body.This operation can take place over 2/3 days incidentally.

Collection for 1 {BMH} is usually done under General Anaesthetic and as this has not been mentioned to me, I assume will not relate to my case. Should it so do, I will explain later. However collected, the stem cells are labelled and taken to Pathology,where they are bagged and frozen in liquid Nitrogen for storage. A chemical , DMSO which prevents the water in the cells forming ice crystals is added prior to freezing Apparently cells can then be stored for up to 10 years quite safely.

The above deals reasonably comprehensively with the reasons for treatment and the initial procedures involved in collection and storage of stem cells. The details of side effests, time taken and hospitalisation will be found in a subsequent Hub. I must pay tribute here to the British Leukaemia Research Charity for their excellent booklet on the subject which has filled in qiute a few gaps for me and been a great help..

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