Thursday, May 24, 2007

Happy harvest

In a comment on my last post, my sister wrote ...

"Mom said something about if your M-spike drops to a certain level, then maybe they can harvest your marrow for a transplant at a later date. Is that true? That would be really cool."

Yes, that's true. In fact, a successful stem-cell harvest is one of the goals of my Revlimid therapy. I'll explain ... or try to ...

There are two general types of transplants doctors can do for people with myeloma. They're technically called stem-cell transplants, although I usually just call them bone-marrow transplants, because whenever you say "stem cells" people get all bent out of shape. These transplants, however, involve adult stem cells -- the completely non-controversial kind.

There's an allogenic stem cell transplant, where you get the cells from a donor. There's also an autologous transplant, where you get a transplant of your own cells that have been harvested from your body earlier. With both transplants, you're given a blast of high-dose chemo to kill off your bone marrow, and then you get the nice, fresh cells infused back into your body.

Either one could be in my future somewhere down the road, but the first one they'd give me would be a transplant of my own cells. A donor transplant can be a lot more effective, but it can also be horribly dangerous and kill you. Dr. H talked with us about all of this transplant and harvesting stuff back in March, and she said she'd only recommend a donor one only if every other option had failed. I agree.

The self transplant, though, is a lot safer. It's not going to cure you, but maybe it can hold the myeloma back for a while. Back in the Olden Times (like, until a year or two ago), an autologous transplant was the main treatment for myeloma. It was really all they could do. Now, there are so many cool drugs coming out (like Revlimid) that it's not always a given that a myeloma patient has to have a transplant -- or at least, not right away.

However, there is the possibility that I'll need one (or two, or three) someday, and they want to harvest the cells pretty early before they're all screwed up by a million different treatments. If the Revlimid can knock my myeloma down to a really low level in the next several months, I will most likely head to Mayo to get my stem cells harvested. Dr. H says they'll try to take enough cells for three transplants, and then store them until I ever need them.

She says the whole harvesting process from start to finish can take a couple weeks, but it's not painful or particularly invasive or anything -- it's just really boring. You have to have a bunch of medical tests, then you have a bunch of days of injections to get your stem cells all ready to go, and then they just sort of suck them out of your blood.

So ... I'm not sure when I'll have the harvest. I guess we need to see how the Revlimid is working and then go from there. I'd guess sometime in the fall, but we just have to see.

Anyway. This is the very non-scientific explanation of transplants and harvesting. If you want to know all of the really technical terms, you're going to have to look for another web site. You know, one that doesn't also feature photos of ladybug cupcakes.


mplsdeanna said...

And who doesn't love an extended stay in Rochester? Woo hoo! We'll meet you there!

Karen's sister said...

You explain it really well, probably better than the more technical sites - which would be completely over my non-medical head. I'm glad that's an option, though, because sometimes I think, "What if I don't match?"or "What if the person who matches you doesn't sign up to be a donor?" I'd feel really really bad.

So, I'll keep cheering for the revlimid to do its job - and not just check its e-mail all day and press the "boss button" whenever some plasma cells walk by.

Beth said...

Hi Karen,

I saw Dr. H a few weeks ago and think she's great. The Mayo Clinic is incredible. If it weren't so expensive to travel, I'd go there more often. For now, I'll probably visit once or twice a year.

I had my stem cells harvested in November, 2006. I hated having the triple lumen catheter in. Anything that makes it hard for me to take a shower is at the top of my list of major annoyances. The shots of neupogen weren't so bad until I got near the end of the 10 days. Then I felt some bone pain, and was given pain meds to help with that. The harvest itself was dull, and I slept through it. I went for 2 days and collected enough for 3 transplants.

How are your numbers looking since you've been on Revlimid?


Elizabeth said...

I'm just wondering why they didn't harvest your stem cells right when you got diagnosed, before you even needed any treatment. I'm sure there is a reason, I just can't figure it out. I know, it takes me a really long time to understand all of this stuff.