Sunday, March 17, 2002

Marrow transplant questions

First, I want to thanks all my sibs for so willingly giving up their SSAN for the chance at winning a free trip to Denver and the opportunity to give up some bone marrow! You don't get offers like that very often.

I'll be faxing your information to our lab in downtown Denver tomorrow; the lab will then, in the fairly near future, be sending out the packs of tubes, instructions, etc. You should have the name of the contact person in the pack, but just in case, it's Kathryn Barkley at 303-861-3568.

I really don't know the details of this procedure at all (Deb asked if it was painful). I would presume that the donor would be given an appropriate anesthetic for the extraction, but I have never witnessed or even read about the procedure. Maybe we can find out on-line.
What Brian is proposing is what's called a "mini-marrow transplant"which is a relatively new procedure. Rather than completely destroying my marrow with chemo and radiation, which certainly has it's own risks, and then replacing it in hopes that the donor marrow will "take," what they do with this "mini" procedure is suppress my marrow with chemo and then infuse the donor marrow. With my marrow compromised, and the donor marrow un-compromised (immunologically speaking), the donor marrow would then establish a "graft-vs-host" reaction, attacking and, hopefully, destroying, then replacing, the diseased marrow. Interesting stuff! This is all uncharted territory for me; I have no idea what I'm in for. I just recall that the usual graft-vs-host reactions (which is usually an unwanted problem, wherein an immuno-competent transplanted organ begins rejecting the immuno-compromised body it's transplanted into) is not a pleasant thing for the body that's being rejected. But, hey, what's the alternative? As Mom says, I'd rather be on the right side of the grass so I'll have to put up with whatever comes along.

I've had questions about other folks being donors; I'm told that the best chance for a match is with a sib (with about a 25% chance for a match with any one sibling). Next best would be offspring (but my offspring's DNA has been "contaminated" with that Irish influence from their Ma), and then other more distantly related or unrelated donors. If there is no match with any of my siblings we'll see where we need to look next. I've been wondering about the utility of using cord-blood from my soon-to-be-delivered granddaughter, blood that would otherwise be discarded. I mentioned stem cell collection from unrelated donors, since we collect large amounts of it on L&D for that purpose, but Brian said they didn't use it much in adult patients. I didn't, however, mention the possibility of a grand-daughter's cord blood, but that may not make a difference to him. We'll see.

After my initial illness, during which we found this disease, I slowly recovered my strength and went back to work for almost a couple of weeks. But then, with all that was going on, I began feeling lousy again. I was not sleeping and found it hard to concentrate at work. I lost twelve pounds in two months. I've been off work again for the last week but hope to return again, at least part-time, next week. I hope things go well this time.

Diane joked that if I ended up with some of her marrow, I might suddenly get a craving to start smoking and to study Judaism. I was wondering what I might do if I ended up with some other sib's marrow. I thought if I got Deb's I might start reading a lot of paperback novels and drinking lattes. And with Dan's I'd want to go backpacking and tearing my computer apart. And with Doug's I might unexpectedly join the ACLU!

Oh yeah, and Dan said he'd gladly donate marrow to me now for a kidney at a date to be determined.

That's all for now. I'll keep you updated as things develop. And thanks again for being willing to be a potential donor for me.

Until later,