Transplant Consultation

3/27/13 – I had two appointments at Hackensack University Medical Center. My first one was a follow up with Dr. Jenifer L, Marks to see how I am doing from the surgical biopsy. All has healed well. I again want to mention that Dr. Marks was a highly competent doctor with an extremely pleasant and compassionate approach with her patients.

My second appoint of the day was at the John Theurer Cancer Center with Scott D. Rowley M.D. for my transplant consultation. Dr. Rowley is member of the Blood and Marrow Transplantation Program at the Cancer Center. The consultation lasted 3 hours. I must say that all the information we received was a bit overwhelming. My wife and I received a very detailed education on the process. On top of our discussion we were given a book to read titled: Bone Marrow and Blood Stem Cell Transplants: A Guide for Patients and Their Loved Ones by Susan K. Stewart. The book covers transplants from soup to nuts. It spans from the planning process and finding a donor through living life after your transplant.
For me, the first step will be for my Transplant Case Worker and Transplant Insurance Coordinator (which are provided by the Cancer Center) to get the ball rolling by contacting my insurance and getting the authorization to start the process.
Once this is done I will be asked to provide the contact information for my siblings. What this means is that I will be getting an Allogeneic Transplant. With this the stem cells or bone marrow will come from a donor. The reason I am not getting an Autologous Transplant (which would be transplanting my own bone marrow) is that we basically have two goals with the transplant. 1. Eliminate Mantle Cell Lymphoma from my system.  2. Provide me with a new, uncompromised immune system. By getting someone else’s healthy bone marrow, it will see any remnants of my MCL as foreign cells and attack and kill them.
An interesting thing I learned was that donors need to be a tissue match with me. I had thought they had to be a blood type match, but this is not true. Actually if the donor’s blood type is different from mine, after the transplant my blood type would change to be the same type as the donor.
There is a 1 in 4 chance that my siblings are a match with me. If they are not a match there is a Bone Marrow Donor Registry that will be searched. As a 3rd option, my daughters could be donors. This would be what is considered a “half match”. There are some complications with this but it has become more and more popular over the past year.
Once the up front leg work is done and a donor is found we then are in a waiting game. We will see how effective my Ibrutinib treatments go. Assuming all goes great; Dr. Goy will give Dr. Rowley the go ahead with the transplant. The transplant will require me to get some chemo therapy/radiation to knock out my own immune system. I will then get the transplant. I will need to be in the hospital for about 3 ½ weeks. Once I get to go home I will need to be isolated for another period of time that could span from 3 to 6 months.
All I can say is WOW!!!! This was an awful lot to take in. And there is much I left out (such as  all the risks that come with a transplant). At the end of the day I can will listen to the experts and do what they think is best for me. But what I really need to do is to put this in in the hands of God.
"We put everything into the hands of God." 2 Corinthians 1:9
More to come…

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