Monday, August 3, 2009

Stem Cell Harvest and Scans

As always, it has been a long time since my last post. A lot has happened since then, but not much has changed the last few weeks. We have asked many questions, of many doctors, and received very few answers. My most recent scans were performed on July 22 in New York. The scans show no new tumor growth, only the same questionable spots from previous scans that are still believed to be scar tissue. I am very thankful for these results, as significant tumor growth would make me ineligible for the 8h9 clinical trial that I have been anxiously awaiting.

Before the scans, beginning June 8, I began my 15th round of chemotherapy. It was very uneventful, as are most rounds recently, which is a very good thing. My 16th cycle of chemotherapy began on June 29. It too was uneventful. My scans, normally scheduled during my off week between cycles, were not scheduled until July 22. The delay was necessary because my scans were scheduled along with my stem cell harvest to prepare for the 8h9 clinical trial. Because I have had so much chemotherapy, my body is not able to produce enough stem cells for collection. To get around this, I was given a drug called Neupogen (G-CSF). This drug can be given at home, but unfortunately, it is an injectable, meaning Marissa had to give me multiple shots in each arm for 8 days. She did a fantastic job, but she was not thrilled.

My stem cell collection began on July 23. To collect the cells, an oversized IV line is placed in each arm. Blood is drawn out of the body from one arm, run through a centrifuge machine, and then given back through the other arm. Although very little blood is out of the body at one time, over the 5 hour process, the entire volume of the body’s blood is removed three times. Some patients are able to collect their required amount of cells in a single collection. Unfortunately, I was unable do this. I was told that I needed to collect a total of 7 million stem cells. On the first day, I was only able to collect 500,000 cells, or 0.5 million. I went back on Friday, July 24, hoping to collect more cells, but only produced 400,000 that day, giving me a total of 900,000. The facility was closed on Saturday, but open Sunday. On Sunday, I was able to produce only 200,000 stem cells, totaling 1.1 million. I was told that I can only collect for 5 days without taking a break, and after doing the math, it was apparent that I was not going to be able to collect enough cells. On Monday, July 27, my doctors decided to stop collecting. I was told that I needed to take at least a 7 – 10 day break to recover, and that they would attempt to collect again using a different stimulating drug called AMD. They also had trouble during collection finding veins that would hold up to the oversized needles. For the next round of collection, they have decided to replace the central line in my chest with a larger version. For this, they are scheduling surgery and I will, hopefully, only spend one night in the hospital. In the meantime, we are waiting for insurance approval for the AMD and to be scheduled for surgery.

The problem that all of this presents is that I have now been off of chemotherapy for almost a month. I am nervous to go without treatment for so long before entering the 8H9 clinical trial. We are sitting on pins and needles waiting for a phone call from New York, which they tell me will be on Wednesday, August 5. If all goes as planned, I will return to New York for surgery and another collection starting Tuesday, August 11. If my insurance decided not to cover the new drug or waits too long to do so, I will begin chemotherapy on Monday August 10.

This is essentially a repeat of the last post, with a little bit of added drama. As always, I am sorry it took so long to update, but we have been waiting for weeks on these answers, which we still don’t have. Thanks again for your thoughts, prayers, and cards. Thank you, also, to those of you who wished me a happy birthday. I was able to celebrate with Marissa and her mother, Christine, in Knoxville, before returning home on Saturday. I will make a short post, hopefully by the end of this week, when a decision is made about my future schedule.