Tuesday, October 19, 2010

Day 6 - Waiting

Chris is still doing really well and other than taking his injections and medications, we are leading a very uneventful life (not that I am complaining!)

We thought that we would take this opportunity to explain this procedure to everyone (since many of you only know the bits and pieces we have explained).

For those of you who don't really know what stem cells are (I didn't really know until we started this), they are made in the bone marrow are known as "mother" cells as they are capable of making another cell identical to themselves and to make other cells, which eventually become red cells, white cells, or platelets.

Chris is having an autologous stem cell transplantation. This means that doctors are planning to collect Chris' own stem cells, fix them, wipe out Chris' immune system and then transplant them back to Chris so that he can grow a new immune system that will no longer attack his neurological system. For this to work, Chris will need to undergo high dose chemotheraphy to ensure that he absolutely no immune system left.

Here is a rundown of how it will work:

There are two phases to this procedure: the collection phase and the transplant phase. We are currently in the collection phase, which consists of one dose of cyclophosphamide (chemo) and G-CSF (neupogen) to lower his white blood cell count and boost his stem cell count. This will cause him to make so many stem cells that they will actually overflow from his bone marrow and into his blood stream. After doing this for 10 days, Chris will have a stem cell collection. During the collection, a needle will be inserted in each of Chris' arms and blood is withdrawn from one arm and circulated through a cell seperation machine to extract the stem cells. The remaining parts of the blood are returned back to Chris through the needle in the other arm. The process can take up to 2 days, with 6 to 8 hours of collection each day. However, the doctors have indicated that we may be able to just do one day of collection.

Next Chris will rest for 2-3 week, so that he can be ready for the second phase. During this time, doctors will treat Chris' stem cells, so that they no longer have the specific cell (the T-cell) that triggers the attack on the immune system. He will regrow new ones that will (if everything works) function normally.
Prior to the second phase, Chris will also have a surgery to have a central venous catheter (known as the Hickman catheter) inserted into a large vein in his chest. This will be used to give blood and drugs throughout the next phase and during his recovery.

The second phase, which will likely start sometime between the middle of Novemeber to the beginning of December. To get rid of his current immune system that is causing MS, Chris will recieve three drugs through the Hickman catheter or IV: Busulphan (chemo) in high doses, more cyclophosphamide (chemo) in high doses and antitthymocyte globulin (an immune suppressant). Following this, Chris will recieve his improved stem cells. It will then take Chris about 6 months to regrow the majority of his immune system. During this time, his ability to fight infections will be extremely low.

So there it is in a nutshell. Hopefully, this clears up questions about how the procedure works. In the clinical trial that finished last February, this procedure was successful in stopping the progression of MS in all patients, and some patients even saw an improvement in their symptoms. The trial started back in 2002, and we have had the opportunity to meet one of the patients who went through the procedure and has seen great results. She went from not being able to walk without assistance to downhill skiing!

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