An Autologous Stem Cell Transplant
Bruce will be receiving an Autologous Stem Cell Transplant which means his own stem cells will be taken before treatment, then given back to him after heavy doses of chemotherapy. It is approximately a one month duration between prep and hospitalization with a six week recovery period. There are three possible sources for stem cells: bone marrow, peripheral blood and umbilical cord. Bruce will use peripheral blood.
When Bruce reaches a point that there is little or no evidence of cancer cells in his blood he will be given "growth injections" for 4 days. We expect these injections to begin around June 9. This causes stem cells to grow faster and move from the marrow into the peripheral blood. When there is enough to be harvested for 2 transplants; the stem cells are collected, frozen and stored. Bruce is expected to begin his hospitalization on June 19. He will receive high doses of chemotherapy for approximately 3 days and then his stem cells will be given back to him.
Apheresis is the process used to collect the healthy stems cells. Bruce will be placed on the apheresis machine and monitor the number of stem cells that are being collected each day. We're hoping this procedure takes place June 13-15.
The new stem cells are administered to replace the diseased bone marrow. The day of Bruce's transplant is referred to as Day Zero. On Day Zero the infusion of the stem cells takes place. The process is similar to a blood transfusion and is given through a vascular access device (VAD) or port. His frozen stem cells are thawed immediately before infusing, at his bedside. Each bag of autologous stem cells will be infused rapidly over five to ten minutes.
Bruce will experience nausea, vomiting, and an unpleasant taste in his mouth. Overall side-effects from the transplant will include hair loss and weight loss from the chemotherapy and he will need several blood transfusions.
Engraftment is the point when his "new" stem cells begin to make white blood cells, red blood cells and platelets and usually occurs 10-30 days after Day Zero.
Because stem cell transplantation is an aggressive form of therapy there will be a degree of complications. He will be in the hospital for approximately 2-3 weeks. After he receives his transplant and is waiting for engraftment to take place, he will be at risk for developing infections and will have limited visitation. He will be encouraged to walk the halls and use the treadmill daily. The staff is very supportive of Bruce and feel he will do well during this time. Bruce is extremely determined.