Harvesting stem cells

For me, it wasn't a problem at all. I had never had any nausea from chemo drugs - but I later found out this was because they gave me an anti-emetic called Zofran. When I was in the chair the week before last having blood, I overheard a nurse talking to a first time leukaemia patient, She was running through the drug schedule and came to the anti nausea meds. She mentioned one I hadn't had, and then said "now this is Zofran. We call this the Rolls Royce of anti nausea drugs, because it is the best." So six years later it's till highly rated by the pro's. It's not cheap, if I remember it was about $100 a tab, but well worth it.

The harvest consists of the following:

Picking a time when your tumour burden is at its lowest and when you are as well as you are going to be.

Induction phase; you will be given intravenous cyclo or perhaps one of the newer meds like AMD 3100.  I don't know the procedure for AMD 3100, but for cyclo it involves a lot of hydration, an infusion of cyclo preceded by a small dose of dex and dear old Zofran and followed by more hydration. For me took about seven hours. I had NO SIDE EFFECTS WHATSOEVER from this phase.

The cyclo performs a housekeeping task and culls all but the youngest stem cells, leaving a very healthy crop.

Next is G-CSF or growth colony stimulating factor. This mobilises the stem cells and forces them out of the marrow, into the peripheral blood stream - hence PBSCT.

This may be an eight to fourteen day course, depending on how quickly you respond. You will have regular blood draws to see how the white colony is doing. When you start feeling bone pain, this means that the  stem cells are forcing their way out from the marrow, to make way for the new ones. For some peole the pain is low, others have a lot of pain. All the recommended back then was paracetamol (tylenol). I got back ache and pain in the hips about 48 hours before I was due to harvest. I harvested enough in one sitting for an SCT - maybe six hours.

When you go for the actual harvest or phoresis, you will be hooked up to a special machine; the machine (an apheresis m/c or device) takes whole blood out of one arm, spins the blood until the stem cells separate out, and the plasma and red blood cells are returned via the other arm. The stem cells are weighed and checked for volume. The actual quantity required varies by centre, but a rule of thumb is 5million/M2. For me this was two small bags.

The stem cells then have a preservative added, and are frozen in liquid nitrogen. The preservative (who's name I can't remember) stops the cells from bursting when they are frozen. The down side is when they  are re-infused, the body temperature preservative smells like rotten sweetcorn (a Maori delicacy) or rotten garlic. It has been known to make the nurses gag. When I went home after the infusion, Lesley made me sit in the back seat of the car with the windows open. Fortunately, it only lasts about 24 hours :) When I had the transplant and had visitors, Lesley would walk up the corridor of the BMT unit and tell everybody who had just had a transplant - by smell alone !!!

That's about it, let me know if you have any questions.

Chris who smells OK now :)