The interesting thing about a Bone Marrow Transplant (BMT – almost like a BLT!) is that they don’t transplant the marrow but simply the stem cells that will create the marrow.
The work up (read chemotherapy) for the Transplant finished yesterday with the final drug Melphalan that is designed to kill off 95% of all my blood cells. There is a significant lag between administering the drug and the depletion of the cells – which all seem to be hanging together at the high end. My neutrophils will drop to 0.0 in the next couple of days but for the time being have jumped up to 6.1 from 2.2 – a last gasp in response to the chemo but there are no cavalry following up – they will die!
My Haemoglobin has gone south already and has dropped below the critical 80 mark – so two units of blood for me today.
We had a good meeting with the transplant co-ordinator Siobhan Mineely who talked us through the next 100 days and beyond. The first 100 days after transplant are critical where the medical team will keep me immunosuppressed with drugs and they’ll watch the blood counts very closely.
My brother Tony is now on his was down to Melbourne, kindly flown by Chris Cabot in our plane, the C510 Cessna Mustang. Chris has collected Tony and Katy from Forbes and will fly direct to Essendon – taking about 1 hour.
While speaking with Siobhan we explored the blood types and compatibility of Tony’s blood.
His blood type is not the same, he is Type A while I am Type O, in time I will take on his blood type! (who knows if his personality will come with it!)
However it was determined that the match of Human Leucocyte Antigen (HLA) was ideal, a 10/10 match.
The HLAs are collections of proteins of the surface of cells called Anitgens. They are important for the correct function of the immune system and are important for the body to recognise itself – ie. to kill off any unwanted cells that are a threat and leave the good ones – we don’t want the organs to be attacked (too much at least).
There are many HLAs which are divided into two main classes. Class I antigens are responsible for displaying that a cell is infected by displaying the virus outside the cell and Class II warns the immune system of a new virus in the body.
The other critical thing checked with the donor is their Cytomegalovirus (CMV) status. 75% of the population are CMV positive. Luckily we both tested positive to CMV so the matching is even better.
So for now I am waiting on my 20 hour infusion of cyclosporin immune suppressant drug and then I will be ready for the big day tomorrow!