So, today is the day I get my stem cells back- yeah- happy birthday to my new bone marrow.    As I mentioned before we harvested my stem cells out of my bloodstream over the course of 3 days last week , July 1-3,  and I managed to provide 11.7 million/cells/kg.  Since I weigh about 67 kg (DO NOT convert that to pounds please!) ,  thats actually 784 million stem cells.   Attempted to post some pictures below but I think only one is showing up.  This is  me with all my pherisis plumbing.  I kept saying “I AM THE BORG”  to all the nurses.  

 

Lots of Plumbing!
Lots of Plumbing!

The only hiccups with this process relate to my being one of those patients who wants a special order stem cell transplant. If Burger King can manage it, shouldn’t Duke?  It is Duke’s standard to collect enough cells for 2 transplants, one for now, and one for later, if the patient needs one after relapse.  At many centers in Europe, they collect enough cells for 3 transplants, and I made that request for myself.  The rationale is that many of the more agressive chemo regimens that are effective after relapse require a stem cell transplant and there also some experimental (potentially curative) options with mini-allo/auto transplants that I might want to explore in the future.  So I want to keep my options open.  It seemed like a straightforward request, but my physician, Dr. Gasparetto, had to give special permission for me to collect enough cells for that in the first place.  Then last night, after asking all day how many cells they were going to give back to me (which is not apprently something most patients ask becuase no one could answer me), I finally found out that they were planning to give me half my cells-  6 million!  That’s 3 times as many as the minimum and would barely leave enough in the liquid nitrogen freezer for 2 more transplants.  So, I had to send them all back to Dr. Gasparetto to sort it out.  Apparently she agreed with me, because now the plan is to give me just 3 million cells. Whew.  The second thing I had to get assertive about was that had me come back today at 8am.  I didn’t think about the significance of this until last night,  then got worried.  Since I hadn’t gotten my Melphalan until 1pm,  they really should wait 24 hours to give me my stem cells- otherwise they risk running into the chemo, which will of course kill them  From what I read, 20 hours is probably safe, but there is a lot of variability in how quickly people clear melphalan, so I really preferred not to risk it just for sake of Duke’s convenience.  So, I brought this up this morning and it seems that 24 hours is actually their standard, but somehow they had not remembered it when they scheduled me so early. They did agree  to wait until 1pm to infuse my cells.  so here I am, just hanging out at the ABMT clinic.  It all really makes you wonder how much poorer the care is for patients who don’t have the advantages I do (being a myeloma researcher is not common among myeloma patients)!