I found out two weeks ago that I have six donor matches. Six, in the stem cell transplant world, is a lot. Many people are happy for just one, and some have to settle for partial matches. Essentially, my doctors can choose the fittest of the six, and the determinations are not much different from those made during a high school dodgeball game. Candace and Simone are smoking in the corner, so they’re out. Besides, they’re girls, and so is Nikki, so they’re not getting picked first. Obviously. (No, seriously. Male donors are preferred because if female donors have ever been pregnant, their babies can expose them to foreign genetic material—their partner’s—which complicates the grafting process.) Johnny is on the fast track for liver cirrhosis, so he’s not the best choice. That leaves Flynn, the tortured artist, or Ryan, the Olympic swimmer. We’ll go with Ryan, thank you.
So, with six good matches, you would think I’d be packing my bags for a Tucson winter with all the other snowbirds. You’d be wrong. Because…a funny thing happened on the way to the transplant.
I started getting better.
Let’s rewind a bit. Back on August 4, I wrote:
“Since I don’t have a donor yet, my doctor has recommended I move forward with a round of immunosuppression therapy, which, at first, sounds counterintuitive. After all, one of the hallmarks of my illness is that my immune system sucks. However, not all the white blood cells in the immune system are the same. Essentially, one group of cells, T-lymphocytes, are attacking my bone marrow. Immunosuppression therapy puts the kibosh on these cells, allowing my bone marrow to get back to making stem cells, which in turn make blood cells. Theoretically, this would reduce my need for transfusions, and my body might even respond positively enough that a transplant may not be necessary.”
Theoretically, this would reduce my need for transfusions, and my body might even respond positively enough that a transplant may not be necessary.
I received this therapy in mid-August, and for the past month, I’ve watched my numbers go up—quite a bit. And not just the minimal amount needed to avoid transfusions. To illustrate, I’ve made a couple of charts1:
Essentially, in a little over a month, my hemoglobin has gone up 50%, meaning I don’t get short of breath and my heart doesn’t get overworked beating blood. In the same time period, I’ve gone from having virtually no clotting ability—to the point that I couldn’t really brush my teeth some days for fear of gum bleeds—to being almost normal. And here’s the kicker: My immune system is recovering, too, with my neutrophils—the infection-fighting white blood cells—rallying. So much so that my doctor has taken me off of prophylactic drugs. For reference, here’s what Cancer.org says:
“When the ANC [absolute neutrophil count] drops below 1,000 it is called neutropenia (new-truh-peen-e-uh)2. Your doctor will watch your ANC closely because the risk of infection is much higher when the ANC is below 500.”
On September 2, I had an ANC of 10, which is 50 times below the danger zone. Today, it was 1,430.3
So, what does this all mean for me? We don’t know yet. My doctors want to wait another several weeks to see how completely my bone marrow recovers before we make a decision how to proceed. Transplant is a big deal and it is not a slam dunk. Nor, it should be noted, is relying on immunosuppression therapy, as I may continue to do. The former is curative, but there is a risk of graft-versus-host disease (GVH). With the latter, I avoid chemo and GVH, but there is a risk of relapse. All of that, however, is secondary at the moment. For now, what is important is that: 1) I’m feeling better; 2) If I continue improving, I may not need transplant; and 3) I’m killing my zombies.
- Apologies if they appear to come from the Jason Chaffetz School of Table Design [↩]
- According to the New Oxford American Dictionary, this is “the presence of abnormally few neutrophils in the blood, leading to increased susceptibility to infection”. [↩]
- I didn’t bother to graph it because I’ve been so close to zero for so long that there was no difference between me and the X-axis. [↩]