Phase II

This coming week will begin the second phase of my treatment for Non Hodgkins Peripheral T-Cell Lymphoma.  Phase I was a Clinical Trial at Duke Cancer Center, consisting of 24 chemotherapy treatments spread over 28 weeks.  That phase was successfully completed last month, and I am now entering Phase II of my treatment.  This new phase involves a stem cell transplant (aka bone marrow transplant), also to be performed at Duke.  I will be receiving an Autologus Transplant, which means that the transplant will utilize my own stem cells, rather that cells from a donor.  One of the main advantages of a "Auto" transplant is that my body will be much less likely to reject my own cells, versus those from another person.

To say that stem cells transplants are complex (and expensive) is an understatement.  The Adult Bone Marrow Transplant at Duke began in 1983 and has performed over 2000 transplants.  They currently perform about 200 adult transplants each year.  Duke also has a Pediatric Bone Marrow Transplant Program, which is separate from the ABMT program.  Our daughter was an RN in the pediatric program a few years ago and has been a tremendous resource in helping us understand what lies ahead.  The concept is fairly simple and consists of 3 basic steps: 1. Remove a quantity of stem cells from the blood stream and freeze them for later use.  2.  Administer high dose chemotherapy which is meant to destroy any remaining cancer cells.  Unfortunately, this also destroys the normal cells of the bone marrow and the immune system.  3.  Transplant or infuse the stored stem cells back into the bloodstream, where they migrate to the bone marrow.  Usually, within a couple of weeks, they begin making new white blood cells, followed by new platelet and new red blood cell production.  This rebuilding process takes months, before the patient has reestablished their immune system and is capable of resuming more normal activities.

Next week we head for Duke again, to meet with Dr. Michael Horwitz and his transplant team.  A series of tests will be performed to evaluate heart and lung functions, and of course a complete blood workup since it is not possible to enter a cancer related facility without having blood drawn.  Then we will attend a class for New Tranplant Patients, designed to cover the very long list of details and duties for patients and caregivers.  Finally, a meeting with Dr. Horwitz will review status, answer questions, and hopefully get the green light to proceed.

The stem cell collection or "harvesting" will take place the week of February 18, and the following week I will be admitted to the hospital, for 5 days, to complete the high dose chemotherapy.  Then we will move into an apartment near the hospital, which will serve as home base for our daily visits to the transplant clinic for testing and evaluation.  So the last part of February and most of March will be spent as residents of Durham.  Where better to be located during March madness (an epic basketball event, should you not be aware).

We are beginning to pack boxes with toothpaste, underwear, food, computers, shampoo, dish soap, coffee filters, books to read, and the myriad of other items it takes to live away from home for 6 weeks. We're making a list and checking it twice.  We are trying to look at it as an adventure, although I doubt I will be feeling like doing a lot of activities.  But it is what it is and we will get through it just fine.  In June we will look back and smile, glad that we have moved beyond transplant, and thankful for all our blessings along the way.

In the meantime, keep us in your thoughts and prayers.