The first 5 days (or Coming Soon at a Hospital Near Me)

I’m not there yet, but this is what I have to look forward to when I get admitted to the hospital.  This is the current plan.

The first five days will be used kill my bone marrow.  At this point I will have no immunity.  I wonder if a baby has more immunity that is passed on from its mother.  Next comes the cord blood stem cell transplant.  If things work, I will slowly generate healthy bone marrow that will produce healthy cells.  I will stay in the hospital for several weeks and once discharged will be in home isolation for 100 days, with daily visits to High Dose for part, if not the whole time.

The Killing Stuff:

  • Fludarabine – once a day for 5 days, a 30-minute infusion
  • Cyclophosphamide – the first day, administered over a 1-hour infusion.  Since this drug can damage the bladder, it requires the placement of a catheter to continuously wash out the bladder.   I think they said that I would have the catheter in place for at least 24 hours. This one does not sound fun, at all.  Actually, none of this sounds like any fun at all, but there is no good alternative.
  • Total Body Irradiation (TBI) – 3 sessions about 12 hours apart where my whole body gets zapped.  Will I glow in the dark?

The Rebuilding Stuff:

I get the following drugs at the time of transplant or just after.   They are designed to reduce the risk of GVHD (graft-versus-host-disease) where the transplanted (foreign) cells react adversely with my own tissues.

  • FK506 and Cyclosporin – works towards preventing any rejection of the transplant
  • Methylprednisolone – a steroid used to reduce inflammation

The Rebuilt Me:

  • To be determined.  It will take awhile.