Wednesday, March 05, 2008

More Marrow Questions and Answers

During my last two visits I asked my hematologist a few more questions about the marrow transplant. Partly because I find it easier to process this stuff when I'm not going through chemo, and also because people have been asking questions.

First of all, a reminder as to why I need the transplant: I have what's called monosomy 7; that is, one of the two homologous monosomes that make up my seventh chromosome is missing. ("Homologous" is a fancy way of saying "identically structured"; an advantage of having a pair of identical monosomes is that one can be backup for the other.) The transplant is actually of the stem cells from healthy marrow. Without healthy marrow, I'm at an increased risk of having the leukemia recur again in the future.

Héma-Québec takes 12 to 14 weeks to search through the entire international registry; if no match is found after that, then we have to consider other options.

Door #1: An autologous transplant, which in essence means that I'm giving myself a transplant. The upside is that I match myself perfectly, and run no risk of rejection. (Part of the transplant process involves 4 to 6 weeks in isolation. Part of that time, I gather, is spent recovering from the chemo they administer before the transplant; but I'll also be monitored to make sure my body doesn't rebel against the invasion of foreign marrow.) The downside is that since I have chromosome damage, the chances of this actually working are slim.

Door #2: A transplant from a donor who only partially matches. This increases my chance of rejection.

Door #3: A haplo transplant, from a donor who only matches me halfway—i.e., a parent. This also increases my chance of rejection—significantly enough that it's entirely possible the process could kill me.

What all this means is that we're increasing our efforts to get people to register as donors (and to tell other people to do so), and to get them to do it in a timely manner. My hematologist said that it is possible to extend the search time if we're actively getting a significant number people to register, but delays just increase the chance of the leukemia recurring. Our revised message involves us making it clear that time is of the essence. If you haven't told your friends to donate yet, do it now.

I'll be creating a web page with all the information people need (a revised version of Tamu's Facebook text) by week's end. I'll send out the link as soon as it's up.

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