The Procedure

Summary of Chris' Stem Cell Collection and Transplant

Chris had an autologous stem cell transplantation (sometimes referred
to as a bone marrow transplant). Stem cells 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.

Basically, this procedure involves collecting Chris' own stem cells,
fixing them, wiping out Chris' immune system and then transplanting them
back to Chris so that he can grow a new immune system that will no
longer attack his neurological system.

There are two phases to this procedure: the collection phase and the
transplant phase. The collection phase consists of one dose of
cyclophosphamide (chemo) to lower his white blood cell count and  daily
G-CSF (neupogen) injections to boost his stem cell count. This caused
Chris to make so many stem cells that they will actually overflow from
his bone marrow and into his blood stream, which can actually be pretty
painful.

After doing this for 8 days, Chris has his stem cell collection. During
the collection, a needle was inserted in each of Chris' arms and blood
was withdrawn from one arm and circulated through a cell separation
machine to extract the stem cells. The remaining parts of the blood were
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, since Chris produced so many stem cells, they were able to just
do one day of collection.

Next, Chris rested for a month, so that he could be ready for the second phase. During this time, doctors treated Chris' stem cells, so that they would no longer have the specific cell (the T-cell) that triggers the attack on the immune system in MS patients. The hope is that he will regrow new T-cells that will function normally.
Prior to the second phase, Chris also had a PICC line  inserted into his arm and fed up to his chest that was used to give blood and drugs throughout the next phase and his recovery.

The main objective of the second phase was to get rid of his current immune system that was causing MS. Chris received  Busulphan (chemo) in high doses, more cyclophosphamide (chemo) in high doses and antitthymocyte globulin (an immune suppressant). Once Chris has absolutely no immune system (literally a white blood cell count of 0),they give Chris his stem cells back. After that comes the hard part, when Chris needed to grow a new immune system. This is when he was at high risk to get an infection and he is constantly getting antibiotics and blood transfusions.

Timeline

October 16 - 4 hours of Cyclophosphamide (chemo to lower white blood cell count)

October 17 - Chris admitted into hospital overnight after he has problems with Cyclophosphamide

October 18 - 25 - Daily Neupogen injections ( to boost stem cells)

October 22 - Physical and blood work to check for infections

October 23 - Chris goes to emergency room due to pain caused by Neupogen

October 25 - Stem Cell Collection

Recovery for the month of November

December 2 - Planning appointment, and PICC insertion.

December 3 - Admitted as an out-patient to the hospital. Two hours of Busulphan

December 4 - Two hours of Busulphan

December 5 - Two hours of Busulphan

December 6 - Two hours of Busulphan

December 7 - Rest day

December 8- Chris start Cyclophosphamide for the next four days. This chemo requires that you to drink every hour and go to the washroom every hour.

December 9 - Cyclophosphamide and an infusion of Antithymocyte Globulin (ATG). While the chemo drugs will wipe out his white blood cells, this ATG will wipe out his T cells (the cells that are behind multiple sclerosis). Chris has reaction to ATG and is admitted to the hospital.

December 10 - Chris remains an in-patient and has additional doses of  Cylclophosphamide and ATG.


December 11 - Chris  remains an in-patient and has additional doses of  Cylclophosphamide and ATG.

December 12 - Chris has ATG and hydration. He is discharged from the hospital and goes back to being an out-patient.

December 13 - Stem cell transplant (Chris white blood cell count under 0.1).

December 14 - Post transplant check- up, blood tests and IV antibiotics.

December 15 - Chris is admitted with an infection.

December 16-22 - Chris has a high fever and is closely monitored at the hospital. He undergoes daily IV antibiotics, pain killers and blood transfusions. He is unable to leave his bed without help and becomes extremely confused and disoriented.

December 23 - Chris' white blood cells rise to 0.3 Extremely high fevers

December 24 - White blood cells rise to 0.9. Chris shows huge improvements and is able to get out of bed.

December 25 - White blood cells rise to 1.7.

December 26 - Chris is discharged and becomes an out-patient.

December 27 - January 3- Daily check-ups to recieve IV antibiotics and blood tests.

January 4 -  Chris is discharged from the out-patient program and begins weekly appointments.

January 26 - Chris moves from weekly appointments to monthly appointments

March 1 - Chris is approved to return to work.