Mission (Stem Cell Collection) Accomplished
My last post was on Day 12 (Sunday March 1). I had just started receiving twice daily shots to boost my white cell counts and stimulate stem cell production. A couple of patients had told me the shots would cause extreme bone pain, but I also heard that taking Claritin twice daily starting several days ahead could prevent/reduce the pain so I did that and only had one night of annoying aches.
By Wednesday morning, my white count, which had sunk during the previous week, had increased enough that the nurses said I could start stem cell collection the following day. That was sooner than I expected and welcome news.
On Thursday morning at 7am, we went to the Cell Apheresis unit at the main hospital where I was hooked up to a machine that drew my blood from one line, spun it through a centrifuge that separated out and then collected the stem cells in a bag, and returned the rest back to me through another line. It was painless and lasted about 3.5 hours, with Mom and Dad at my side the whole time (pics below). Of course they have been an AMAZING caregiver team while we have been in Little Rock.
Most institutions that treat myeloma try to collect at least 5–10 million stem cells expecting that they will need at least a few million stem cells per transplant. They are not always successful collecting enough cells, in part because some myeloma meds impair stem cell collection. One of the reasons I decided to come to UAMS is that the myeloma center here generally does a good job of ensuring (by avoiding certain myeloma meds early in the process and adding the chemo that I took during the visit) that patients will produce and collect more than enough stem cells for multiple transplants (or other possible future uses if needed). Their goal is 20 million, to be collected over as many days as necessary, with a minimum collection of 2 days even if the output is 20 million the first day. Luckily after one day I had over 22 million stem cells, and by the second day a total of 38 million! Below is me holding the bag with over 16 million stem cells from the 2d day. I expected a larger bag to hold so many millions but I guess those cells are tiny.
After completing stem cell collection, I was able to have the “central line” in my neck removed and got the green light to head home. The plan is I will go back to LA for a few weeks of R&R and then return in a few weeks for the next recommended step in the treatment process: a stem cell transplant. I am probably going to do it.
In the meantime I feel pretty good (back to normal though maybe a bit weaker and careful not to stress the GI system) and am really glad I made it through this phase with no delays or hiccups (though I did have one day of actual very annoying periodic hiccups due to the steroids!) and achieved the goal of producing so many stem cells. Mission accomplished!