Bone marrow transplants

            Well, I made it to Massachusetts via Megabus. Today, while I do laundry and fit back into home life, I’m enlisting Jim’s aid for the blog. Here’s a concise email he sent our kids on David’s upcoming treatment.

            The purpose of David’s chemo is to destroy his bone marrow and blood cells, both the good and the cancerous cells. This may take several rounds of chemo and possibly radiation. It has the effect also of deleting his immune system permanently. Once this is accomplished, the purpose of the transplant is to start David fresh with new marrow from another person. For the rest of David’s life, his new marrow will produce blood cells (red, white, and platelet cells) and provide him an immune system. This new immune system will be genetically the donor’s, not David’s. The closer the genetic match, the more likely this is to work. The main risk of transplant is that the host (David) will attack the “graft” or that the graft will attack the host. The main benefit is that the graft will not be cancerous and will even help kill the last of the cancer.
            The essential thing that is being donated is stem cells from the donor. Stem cells can be hemopoietic (they differentiate and grow into various kinds of blood cells and marrow cells) or embryonic (they are capable of growing into any kind of cell at all). All people have stem cells all the time; younger people have more of them. The donated cells can be withdrawn directly from the center of bones (usually the pelvis); this is called aspiration. Or, they can be withdrawn from the blood that circulates throughout your body. The second method is probably what will be used in our case. The donor receives a drug for several days to increase the number of stem cells in the blood. Then the donor is hooked up to a machine for several hours. It’s similar to kidney dialysis that many people do several times a week for years and years. In this case, instead of removing waste from the blood, the machine removes stem cells and then returns the blood to your body. It is necessary for the donor to be in Bethesda, Maryland to make the donation.