Today I received the stem cells which will become my new immune system! The infusion itself was relatively uneventful (a gravity-fed bag of cells flowed into my PICC line for about an hour) but it represents a big day for me and a shot at one day having a healthy immune system. After the infusion the transplant team came in and sang happy birthday to celebrate!
While I spent the last week in the hospital focused on getting through chemotherapy to gear up for this transplant day, the next few weeks are focused more on preventing infections and managing symptoms related to the continuing drop in my immune function as my white blood cell count approaches zero. Realizing that I’m going to be feeling a lot worse before I start feeling better again, I don’t plan on updating this website until near the end of my hospital stay when my numbers begin to elevate again (which fingers-crossed is a couple of weeks from now). For now I’m happy to report that things are looking good and I’m eager to continue on this arduous but exciting journey!
I just finished my last bag of pre-transplant chemotherapy! As of this morning the doctors said they are pleased with my numbers, and things are looking good so far. Even though the chemotherapy infusions stopped today, my blood counts will continue to drop (to near zero) over the next couple weeks during which I’ll be feeling really lousy. For now though, I feel surprisingly good (my medications are doing a great job of controlling the pain and nausea) and while my blood counts are high enough I’m even allowed to take occasional little walks around the hospital with a mask.
Medical details: Over the last week I had a tri-lumen PICC line added through my left brachial vein to allow simultaneous infusion of drugs and blood products over the upcoming weeks (I’ll likely be requiring blood and platelet transfusions). While I still have an infusion port on my chest, accessing it is an infection risk so the transplant team has chosen not to use it during my stay. The chemotherapy drugs I’ve been on over the last week are: carmustine, cytarabine, etoposide, and melphalan. Tomorrow is transplant day, where I’ll receive my previously-collected stem cells through my PICC line.
A few days ago I got the phone call I was hoping for – We are proceeding with a bone marrow transplant! An autologous bone marrow transplant is a procedure which may give me a chance at growing a new and healthy immune system (capable of fighting the cancer) from stem cells previously collected from my blood.
When I first started chemotherapy in August the hope was that it would suppress my lymphoma enough that I could safely proceed with the transplant. While the chemotherapy regimen used (CHOP) was highly effective at suppressing most of my cancer, a patch of highly active lymphoma near my left arm did not respond to the chemotherapy (it actually grew during treatment!) and the bone marrow transplant (initially scheduled for January) was cancelled.
Several weeks of daily radiation treatment was ordered that focused on the active cancer that remained. Radiation treatment turned out to be highly effective at suppressing the lymphoma at that site, but a CT taken near the end of treatment raised the suspicion that the lymphoma was coming back elsewhere in my chest (a situation which would take a bone marrow transplant off the table again). A decision was made to take a few weeks off of treatment then follow-up with a new CT to see if the cancer was still growing. For the last few weeks I didn’t know if I would be proceeding with a bone marrow transplant, starting-up a different chemotherapy regimen (GDP), or pursuing immunotherapy (CAR T). I had the follow-up CT a few days ago and the lymph nodes in my chest have stabilized, so we are proceeding with transplant. I waited to update this web page until I knew with confidence what the next step of my treatment was going to be.
The last few weeks were a nice vacation from cancer treatment. I enjoyed putting a little bit of time back into some of the activities that I had to put down when I began treatment last year (programming, electronics, and YouTube). I even grew back a little hair! I know the transplant process (which starts next Wednesday) will be rough (with much higher doses of chemotherapy than before), but I’m excited to be moving forward with treatment. My scheduled transplant day (when I’ll actually receive the stem cells which will grow my new immune system) is March 27, 2019. I hope I’ll be able to share a positive update sometime around then!