Bone marrow transplants, some of what I have learned
(cells in the bone marrow, illustration)
My family has learned a lot in the last few months about cancer, lymphoma, and now bone marrow transplants. This is an attempt to just share what I learned about it all. Please leave a comment after if you like, and share your thoughts.
Having been through a pretty grueling round of chemotherapy, that actually destroyed the tumors in my dad's brain :), we are now facing him needing a bone marrow transplant. The purpose of this is to make sure that there is no recurring cancer. While NO cancer is showing up, its very possible there is an undetectable amount in his blood stream that could cause the cancer to return later. A bone marrow transplant makes it so that any small amounts of cancers can be done away with.
The best news of all, is that now doctors need not go into the bones themselves to access the needed stem cells they are seeking. Through injections and production within the bone marrow, they can access what is needed straight from the blood stream. These are mother cells, also known as pluripotent stem cells. They have the amazing ability to make the 3 needed types of blood cells, white, red, and platelets. This helps in a "rescuing process" when a person, after heavy doses of chemotherapy, has had their immune system taken down to "zero". This is how the remaining possible cancerous cells are destroyed.
The rescuing process includes transplanting the mother cells, the pluripotent stem cells back into the bloodstream. What is amazing, is that the doctors don't know exactly how these mother cells get BACK into the bone marrow, but they know that they do. They then these amazing cells root themselves into the bone marrow and get on with the business of making new cells for the patient. It is simply amazing this can be done! It has proven very successful as well, and eliminates the need for further chemotherapy in the future. (or that is the hope, and what they have seen very often)
During the collection of these stem cells, straight from the blood stream, there is a centrifuge, which through some kind of spinning separates out the exact stem cells they are after. The centrifuge process can determine the molecular weight of the cells. These have built up in the bone marrow, then come out into the blood stream, after there have been injections of special medicine that increases production of these kinds of cells. One of the side effects can be bone pain, because the production is high inside the bones. Pain medicine can relieve this. The centrifuge process can determine the molecular weight of the cells. All this is done using a triple line catheter into the chest area, and makes it easy to pump the rest of the blood they are not "taking out", right back into the body. Its just an incredible process.
The white blood cells cannot "come back" to what they were as quickly as the red and the platelet cells. So the patient must be careful to not come into contact with any germs and bacteria. They can easily get sick during this time, and shouldn't have any soft serve types of ice cream, or shakes, or cold deli meats. Also anything that could collect dust is discouraged. No balloons, flowers, not even silk flowers are allowed in the room. Normally one's system can easily handle the things that can "lurk" unseen on these things, but not during this time. During the neutropenic phase, it can possibly become life threatening. White blood cells only live for 6-10 hours. There are also 5-6 different types of white blood cells, something I didn't know before. The doctors are most concerned about the two kinds of white blood cells that do the most "fighting" for the body.
The patient is neutropenic when their immune system is taken down to zero. They do not need to be isolated during this time, like previously thought in the past. They need to be very careful and stick close to their hospital room though. Exercise is encouraged, as well as wearing a mask to stroll the hallways while neutropenic. Eating something small at least every day is encouraged also. The stem cells are taken down to freezing in a controlled rate freezer. They are stored in liquid nitrogen under very protected environments so it can always be negative 197 degrees. They are put into 70 ml bags with a cryopreservative which keeps the cells in tact. They bring these bags back to the correct temperature in a 37 degree water bath, at the patients bedside, one small bag at a time. Once this is done, the cells cannot be refrozen.
I will update more later, as I learn more, and after the process :) Please let me know if you saw any mistakes in my understanding of what happens during this whole process.
Please lift Jon up in your prayers with us, as he goes through this process very soon. Thank you so much :)