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Wednesday, July 25, 2007

6/20/2007: 30 Days and Counting

"What strength do I have, that I should still hope?
What prospects, that I should be patient?”
-- Job 6:11 (NIV)
June 23 Update: Another small change of planson Friday. Dr. Nakamura decided not to give the second round of chemo, but to reserve that for another week due to the fact that there are no visible signs of return of the lymphoma at this time.
Also, we found that the "primary" donor prospectfor my SCT is not available until August, so we are switching to alternate #1, a 35-year-old male.The date of the SCT remains July 23 for now.
June 20 marked the 30th day before my scheduled admission to City of Hope (COH) for the start of the allogeneic stem cell transplant (SCT) with the actual procedure set to occur on Monday, July 23, if all goes according to plan. Please consult this source provided by The Leukemia & Lymphoma Society for more information about SCT.

While spending several months contemplating this next BIG step, we know the event is now only a month away thanks to the work of the many fine physicians and the care giving team at COH. Out of a possible pool of some 475 potential matched donors, one has been identified as the ideal donor. All that I know is that he is 23 and that his blood type is the universal O+, which will become my new blood type following the procedure.

Perhaps I will get to meet the donor someday since COH has periodic reunions with patients and donors. Dee Dee and I are looking forward to that event as well.Meanwhile, we go ahead in the coming days with the next round of outpatient chemotherapy Friday with Vinorelbine and Gemcitabine which have worked, as expected, to reduce the tumors in the two visible sites. As I have said before, Dr. Nakamura is not now seeking "full" remission of the cancer before the transplant date, only stability and control, which means no visible evidence of the tumors. In fact, for now, that is the only unforeseen consequence that will delay the transplant beyond the scheduled date.

One of the most remarkable things to ponder is how/why a 23-year old is primed to be a stem cell or bone marrow donor. Perhaps he is a medical student or has had a family member need such a donation. We don’t know, but this is more than a simple medical procedure. The form of the donation is determined by the host medical facility where he shows: That is, not all facilities are equipped to prepare or process either type of procedure (stem cell and/or bone marrow).
Sometimes there is a personal or medical reason for the donor that dictates the procedure type. Either way, COH is preparing me for both possibilities.
What's in store? We know that the first 100 days post the transplant is the most critical with regard to possible complications like graft to host disease, which Dr. Nakamura says is unlikely due to the quality of my donor match. Still, those first 100 days will see me hospitalized or housed in a location on the COH campus. This will be followed by three to six months of in-home recuperation before life, hopefully, returns as it was prior to the trial with mantle cell lymphoma that began in March 2006. We are expecting full recovery and a disease-free state at that time for a long time.

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