Most of the following information is directly from the NIH cancer.gov website.
Chemotherapy and radiation therapy generally affect cells that divide rapidly. They are used to treat cancer because cancer cells divide more often than most healthy cells. However, because bone marrow cells also divide frequently, high-dose treatments can severely damage or destroy the patient’s bone marrow. Without healthy bone marrow, the patient is no longer able to make the blood cells needed to carry oxygen, fight infection, and prevent bleeding. BMT and PBSCT replace stem cells destroyed by treatment. The healthy, transplanted stem cells can restore the bone marrow’s ability to produce the blood cells the patient needs.
After the stem cells are collected from Clayton, Ceomi will receive them through her central line (just like a blood transfusion). After entering the bloodstream, the stem cells travel to the bone marrow, where they begin to produce new white blood cells, red blood cells, and platelets in a process known as “engraftment.” Engraftment usually occurs within about 2 to 4 weeks after transplantation. Doctors monitor it by checking blood counts on a frequent basis. Complete recovery of immune function takes much longer, however—up to several months for autologous transplant recipients and 1 to 2 years for patients receiving allogeneic or syngeneic transplants. Ceomi's transplant is allogeneic since her brother is her donor. Doctors evaluate the results of various blood tests to confirm that new blood cells are being produced and that the cancer has not returned. Bone marrow aspiration (the removal of a small sample of bone marrow through a needle for examination under a microscope) can also help doctors determine how well the new marrow is working.
In some types of leukemia, the graft-versus-tumor (GVT) effect that occurs after allogeneic BMT and PBSCT is crucial to the effectiveness of the treatment. GVT occurs when white blood cells from the donor (the graft) identify the cancer cells that remain in the patient’s body after the chemotherapy and/or radiation therapy (the tumor) as foreign and attack them.
With allogeneic transplants, a complication known as graft-versus-host disease (GVHD) sometimes develops. GVHD occurs when white blood cells from the donor (the graft) identify cells in the patient’s body (the host) as foreign and attack them. The most commonly damaged organs are the skin, liver, and intestines. This complication can develop within a few weeks of the transplant (acute GVHD) or much later (chronic GVHD). To prevent this complication, the patient may receive medications that suppress the immune system. Additionally, the donated stem cells can be treated to remove the white blood cells that cause GVHD in a process called “T-cell depletion.” If GVHD develops, it can be very serious and is treated with steroids or other immunosuppressive agents. GVHD can be difficult to treat, but some studies suggest that patients with leukemia who develop GVHD are less likely to have the cancer come back.
(Bolded info is directly from the NIH cancer.gov website.)
Showing posts with label transplant. Show all posts
Showing posts with label transplant. Show all posts
Wednesday, March 18, 2009
Tuesday, March 17, 2009
And we're off. . . . .
Ceomi, Ben and Ceomi's mom, Carolyn, went down to Atlanta tonight in preparation for tomorrow's admittance. She'll be admitted to Emory's University Hospital to begin the stem cell transplant. She should spend about 4 weeks in-patient at Emory. Once she's released from the hospital, she'll spend about 6 weeks at Hope Lodge (an Amer. Cancer Society facility) in Atlanta while her anti-rejection drugs are regulated.
She's due at the interventional radiology lab at 7 am to have her PICC line removed and a central line put into her chest. This central line allows blood to be drawn and medications injected without having to stick her each time. The line will be in place throughout her treatment and has a lower incidence of infection than the PICC line (which was in her arm).
They will start her chemotherapy Wed night and it will run for 6 days. She'll get a day to rest and the stem cell transplant will be on Wed, 3/25. We are hoping that the mucositis (sores in mouth and throat) that was so difficult during the first chemo will either be absent (not likely) or lessened this time. Please pray that the chemo side effects are manageable and respond well to treatment.
In transplant lingo, 3/25 will be her Second Birthday. Her brother Clayton is her donor. He will be coming to Atlanta this Friday and will undergo a series of Neupogen shots. These shots stimulate stem cell production. The stem cells are collected in a procedure (apheresis) that is somewhat similar to dialysis. A line will be placed in his arm and his blood will be pulled out, "strained" to remove the stem cells and then infused back into him. The days of drilling into the donor's hip bones and sternum are happily long gone.
Ceomi has been experiencing neuropathy (numbness & extreme sensitivity, particularly in her hands and feet) since her last chemo in Feb. She has monocytic leukemia and in this type the leukemia cells are more likely to invade the lining of the spinal canal or brain. She has had 2 spinal taps in the last 5 weeks to check for any CNS involvement. So far, while they have shown thickened spinal fluid and the presence of protein, no leukemia cells have been found. They did a MRI on 3/12 to search for any masses and found none. She has diffuse inflammation where the nerves exit the brain and spine but the neurologist attributes the changes to the treatments and not to the presence of leukemia itself. Her oncologist will have steroids administered during the chemo this week and is hopeful that the steroids will help calm the nerves and reduce the pain. A third and hopefully final spinal tap will be done this week to check again for the presence of leukemia cells.
Ceomi continues to be very focused and is in good spirits. Once we have her room number, we will post her address for anyone who wants to send a card. I would recommend using her home address as the return address, in case she is moved. This website is probably the best place to find out how she's feeling. If you plan to visit her, please call her cell or mine to see if she's up to visits before going. The unit she is on is restricted for the protection of the patients. Her immune system will be destroyed by the chemo and will not be re-established until the donor cells engraft. The hospital takes precautions to protect patients with these conditions. No children are allowed and anyone with cold/virus symptoms must not visit. Also, plants and flowers (and some foods) are not allowed due to possible bacterial infections.
We are all aware of the numerous prayers that have been offered on her behalf and are confident that God will see her through this. We are very grateful for the love and support that so many have offered. Please continue to pray for her, Ben and the girls.
She's due at the interventional radiology lab at 7 am to have her PICC line removed and a central line put into her chest. This central line allows blood to be drawn and medications injected without having to stick her each time. The line will be in place throughout her treatment and has a lower incidence of infection than the PICC line (which was in her arm).
They will start her chemotherapy Wed night and it will run for 6 days. She'll get a day to rest and the stem cell transplant will be on Wed, 3/25. We are hoping that the mucositis (sores in mouth and throat) that was so difficult during the first chemo will either be absent (not likely) or lessened this time. Please pray that the chemo side effects are manageable and respond well to treatment.
In transplant lingo, 3/25 will be her Second Birthday. Her brother Clayton is her donor. He will be coming to Atlanta this Friday and will undergo a series of Neupogen shots. These shots stimulate stem cell production. The stem cells are collected in a procedure (apheresis) that is somewhat similar to dialysis. A line will be placed in his arm and his blood will be pulled out, "strained" to remove the stem cells and then infused back into him. The days of drilling into the donor's hip bones and sternum are happily long gone.
Ceomi has been experiencing neuropathy (numbness & extreme sensitivity, particularly in her hands and feet) since her last chemo in Feb. She has monocytic leukemia and in this type the leukemia cells are more likely to invade the lining of the spinal canal or brain. She has had 2 spinal taps in the last 5 weeks to check for any CNS involvement. So far, while they have shown thickened spinal fluid and the presence of protein, no leukemia cells have been found. They did a MRI on 3/12 to search for any masses and found none. She has diffuse inflammation where the nerves exit the brain and spine but the neurologist attributes the changes to the treatments and not to the presence of leukemia itself. Her oncologist will have steroids administered during the chemo this week and is hopeful that the steroids will help calm the nerves and reduce the pain. A third and hopefully final spinal tap will be done this week to check again for the presence of leukemia cells.
Ceomi continues to be very focused and is in good spirits. Once we have her room number, we will post her address for anyone who wants to send a card. I would recommend using her home address as the return address, in case she is moved. This website is probably the best place to find out how she's feeling. If you plan to visit her, please call her cell or mine to see if she's up to visits before going. The unit she is on is restricted for the protection of the patients. Her immune system will be destroyed by the chemo and will not be re-established until the donor cells engraft. The hospital takes precautions to protect patients with these conditions. No children are allowed and anyone with cold/virus symptoms must not visit. Also, plants and flowers (and some foods) are not allowed due to possible bacterial infections.
We are all aware of the numerous prayers that have been offered on her behalf and are confident that God will see her through this. We are very grateful for the love and support that so many have offered. Please continue to pray for her, Ben and the girls.
Wednesday, February 11, 2009
The background
Ceomi was diagnosed with Acute Myelogenous Leukemia (type M5) while on vacation in Chicago on 12/26/08. She was admitted to Northwestern's Prentice Women's Hospital for 3 1/2 weeks and received induction chemotherapy.
Her bone marrow biopsy at the end of chemo was clean indicating that the leukemia was temporarily beaten down. Her doctors recommended a bone marrow transplant (stem cell transplant in the current lingo) as her best course of treatment.
Ceomi was released and went home to SC at the end of January. Her treatment was transferred to the Winship Cancer Institute at Emory in Atlanta. She underwent a round of consolidation chemo there in early February.
Her brother Clayton is a match and will be donating stem cells to her in mid-March. She will be spending approx. 10 weeks in Atlanta receiving treatment with the time divided between a hospital stay and outpatient treatment.
Her bone marrow biopsy at the end of chemo was clean indicating that the leukemia was temporarily beaten down. Her doctors recommended a bone marrow transplant (stem cell transplant in the current lingo) as her best course of treatment.
Ceomi was released and went home to SC at the end of January. Her treatment was transferred to the Winship Cancer Institute at Emory in Atlanta. She underwent a round of consolidation chemo there in early February.
Her brother Clayton is a match and will be donating stem cells to her in mid-March. She will be spending approx. 10 weeks in Atlanta receiving treatment with the time divided between a hospital stay and outpatient treatment.
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