Hi all,
My Dad, 61 yo, is going to do the ASCT this Monday. It's the harvesting part, not the actual transplant yet. What are we expecting during the procedure? Any advice? Thanks.
Forums
Re: Auto Stem Cell Transplant Harvest - What to Expect?
The havest is rather simple. Generally a catheter is placed and the blood then circulated bit by bit through the pheresis machine and the stem cells are removed and blood returned to body.
The transplant itself. . . Day one is high dose chemotherapy. Day 2 is a day of rest. Day 3 the stem cells are reinfused. Over the next 10 days to 2 weeks the stem cells go back into the bone marrow, grow and divide and become the new red cells, white cells, and platelets.
The toxicity is generally with the digestive tract (nausea, mouth sores, diarrhea) and fatigue. Risk of infection is high so he will either be in hospital entire time white blood cells are low or monitored daily as an outpatient.
The transplant itself. . . Day one is high dose chemotherapy. Day 2 is a day of rest. Day 3 the stem cells are reinfused. Over the next 10 days to 2 weeks the stem cells go back into the bone marrow, grow and divide and become the new red cells, white cells, and platelets.
The toxicity is generally with the digestive tract (nausea, mouth sores, diarrhea) and fatigue. Risk of infection is high so he will either be in hospital entire time white blood cells are low or monitored daily as an outpatient.
-
Dr. Jason Valent - Name: Jason Valent, M.D.
Beacon Medical Advisor
Re: Auto Stem Cell Transplant Harvest - What to Expect?
I am in hospital right now. Collecting the stem cells started Nov 1. I went in for 2 Neupogen shots in my belly the first and 2nd day. Then I had the Hickman tri mport put in on that 2nd day. I've got to admit I was scared about them threading a tube through major veins and dumping into heart. But the doctor who did it was a specialist. He did 2-4 per day and had done thousands.
Nov 3 I had 2 more shots.
Nov 4,5 they collected stem cells ( you also get Neupogen shots o.n those days). They got almost 15 million stem cells- enough for 3 SCR and I got a few days off. I just took magazines and my iPad to keep me busy.
I checked into hospital Nov 10 for Malphalan- but my liver enzymes were 10x as high as they had been. So there was a nerve wracking week of checking my liver numbers, doing ultrasound of liver etc. luckily my liver settled down, but the doctors decided to just give me the 140 mg dose not the 200mg dose of Malphlan.
last Saturday, the 17th, was my Malphalan - and it was not a big deal. Sun was a day of rest and
They gave me stem cells Mon- i slept a lot because they gave me Benadryl. My absolute neutrophil count has come down: Weds it was 4500, Thurs it was 2800, Friday it was 1200 and today it was 400. I'm walking 2miles per day in hospital.
I am tired, but not yet at the bottom. I'm nauseaus but nurses have changed anti nausea meds. I brush my teeth and swish with bicarbonate of soda water because Malphalan is especially hard on the digestive tract and most people get mouth sores and diarrhea
I'm starting to think of Christmas and spring- I couldn't think past this time. Honestly, the anxiety was far worse than this has been so far.
Nov 3 I had 2 more shots.
Nov 4,5 they collected stem cells ( you also get Neupogen shots o.n those days). They got almost 15 million stem cells- enough for 3 SCR and I got a few days off. I just took magazines and my iPad to keep me busy.
I checked into hospital Nov 10 for Malphalan- but my liver enzymes were 10x as high as they had been. So there was a nerve wracking week of checking my liver numbers, doing ultrasound of liver etc. luckily my liver settled down, but the doctors decided to just give me the 140 mg dose not the 200mg dose of Malphlan.
last Saturday, the 17th, was my Malphalan - and it was not a big deal. Sun was a day of rest and
They gave me stem cells Mon- i slept a lot because they gave me Benadryl. My absolute neutrophil count has come down: Weds it was 4500, Thurs it was 2800, Friday it was 1200 and today it was 400. I'm walking 2miles per day in hospital.
I am tired, but not yet at the bottom. I'm nauseaus but nurses have changed anti nausea meds. I brush my teeth and swish with bicarbonate of soda water because Malphalan is especially hard on the digestive tract and most people get mouth sores and diarrhea
I'm starting to think of Christmas and spring- I couldn't think past this time. Honestly, the anxiety was far worse than this has been so far.
-
antelope1225 - Name: Cathy1225
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: May 25 2012
- Age at diagnosis: 55
Re: Auto Stem Cell Transplant Harvest - What to Expect?
Nice to hear from you again, Cathy. Hope all goes well with the transplant recovery time. I remember brushing my teeth with a sponge brush...It's good that you can visualize nice future times such as the xmas holidays and spring.
-
Nancy Shamanna - Name: Nancy Shamanna
- Who do you know with myeloma?: Self and others too
- When were you/they diagnosed?: July 2009
Re: Auto Stem Cell Transplant--What to Expect?
Thank you for your reply.
I suppose the procedure is a bit different here in Singapore. The Doctor said that during the harvesting time, my Dad will be given a "lower dose chemo" before the harvesting, and that "it could cause baldness, and the procedure takes 2-3 weeks."
He's been in VTD regime for 10 cycles. I really hope that we can collect enough stem cells for at least 2 procedures of transplant. He's checking in in a few hours.
He does not have a problem with his liver, but he had a history of unknown hepatitis; that is, he had hepatitis but he didn't realize it, and he got cured naturally. He's been prescribed Lamivudine... I hope nothing funky going on with this.
Thanks! Good luck for all of us!
I suppose the procedure is a bit different here in Singapore. The Doctor said that during the harvesting time, my Dad will be given a "lower dose chemo" before the harvesting, and that "it could cause baldness, and the procedure takes 2-3 weeks."
He's been in VTD regime for 10 cycles. I really hope that we can collect enough stem cells for at least 2 procedures of transplant. He's checking in in a few hours.
He does not have a problem with his liver, but he had a history of unknown hepatitis; that is, he had hepatitis but he didn't realize it, and he got cured naturally. He's been prescribed Lamivudine... I hope nothing funky going on with this.
Thanks! Good luck for all of us!
Re: Auto Stem Cell Transplant--What to Expect?
On the paper it was written "cyclophosphamide mobilization." Actually, he was once prescribed cyclophoshamide but he had no response (thus switching back again to thalidomide). Should we bring this up to the doctor? Thanks.
Re: Auto Stem Cell Transplant Harvest - What to Expect?
Hi tpt.
It could be that they do things differently in Singapore, but some of what the doctor said did not
Make sense to me. Baldness does go with chemo, but my doctors wanted metro have NO
Demo for one month before collection- you dont want to injure stem cells and I have heard that
Malphalan does injure stem cells. So doctors here use Malphalan only to destroy the bone marrow
They use Velcade, thalidomide and. Revlimid and Dexamethasone. Have you considered asking
For a second opinion?
Hi Nancy Shamanna.
So nice to hear you encourage me tojoin in forums again It seems this forum is more about facts so I felt. A bit silly that I focus so muck on the emotional impact. and I really jumped the gun on discribing the Stem cell replacent as being so easy. I'm still in the hospital but got moved to to the Critcal Care unit because I got a temp of 104 for 24 hours. And my blood pressure dropped and I devoted a wicked rash.
When did you go through stem cell replacent.?
How was it when you got home?
Do you take maintenance med?
What impact has this had on your quality of life?
thanks, Cathy
It could be that they do things differently in Singapore, but some of what the doctor said did not
Make sense to me. Baldness does go with chemo, but my doctors wanted metro have NO
Demo for one month before collection- you dont want to injure stem cells and I have heard that
Malphalan does injure stem cells. So doctors here use Malphalan only to destroy the bone marrow
They use Velcade, thalidomide and. Revlimid and Dexamethasone. Have you considered asking
For a second opinion?
Hi Nancy Shamanna.
So nice to hear you encourage me tojoin in forums again It seems this forum is more about facts so I felt. A bit silly that I focus so muck on the emotional impact. and I really jumped the gun on discribing the Stem cell replacent as being so easy. I'm still in the hospital but got moved to to the Critcal Care unit because I got a temp of 104 for 24 hours. And my blood pressure dropped and I devoted a wicked rash.
When did you go through stem cell replacent.?
How was it when you got home?
Do you take maintenance med?
What impact has this had on your quality of life?
thanks, Cathy
-
antelope1225 - Name: Cathy1225
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: May 25 2012
- Age at diagnosis: 55
Re: Auto Stem Cell Transplant Harvest - What to Expect?
Hi Cathy..nice to hear from you too! People post in to the Beacon sometimes and then drop away from it, come back, etc. It's all good...I guess we are all in this boat together and trying to help by sharing information. I didn't have melphalan before my SCT either, BTW. iT was cyclophosphamide, for the same reasons as you.
I had an auto transplant in Jan. 2010...so that is coming up on three years now. I was very tired when I got home, and also had to recover from the strong chemo meds, low blood counts , etc. I was really in the care of others at that time, and the medical people and my friends and family helped me out a lot.
Starting about 100 days after the transplant, I started on a low dose of Revlimid...first 10 mg, and then because I was experiencing low neutrophils, that dose was lowered to 5 mg. By this time I was in a CR anyhow. My doctor had planned for me to be on this dose for a year, and that is what we did.
My QOL is pretty darn good considering that I was diagnosed with such a serious disease. I still have to be careful with my energy levels, but since I am not taking any drugs anymore relating to the myeloma, my energy has bounced back. i still have aches and pains relating to the extensive bone damage, but I guess that is to be expected. I get a thorough checkup every three months. i tell my friends and family that I have the most thoroughly checked blood of anyone!
I am always amazed by how great the medical people are who handle us myeloma patients. I wish you all the best, and hope that you are out of the critical care unit soon. Don't worry about being emotional...don't you think that that goes with the territory of having a diagnosis like this, and going through such difficult treatments? I would be kind of surprised if people were NOT emotional about it all! Please keep us posted on your progress.
I had an auto transplant in Jan. 2010...so that is coming up on three years now. I was very tired when I got home, and also had to recover from the strong chemo meds, low blood counts , etc. I was really in the care of others at that time, and the medical people and my friends and family helped me out a lot.
Starting about 100 days after the transplant, I started on a low dose of Revlimid...first 10 mg, and then because I was experiencing low neutrophils, that dose was lowered to 5 mg. By this time I was in a CR anyhow. My doctor had planned for me to be on this dose for a year, and that is what we did.
My QOL is pretty darn good considering that I was diagnosed with such a serious disease. I still have to be careful with my energy levels, but since I am not taking any drugs anymore relating to the myeloma, my energy has bounced back. i still have aches and pains relating to the extensive bone damage, but I guess that is to be expected. I get a thorough checkup every three months. i tell my friends and family that I have the most thoroughly checked blood of anyone!
I am always amazed by how great the medical people are who handle us myeloma patients. I wish you all the best, and hope that you are out of the critical care unit soon. Don't worry about being emotional...don't you think that that goes with the territory of having a diagnosis like this, and going through such difficult treatments? I would be kind of surprised if people were NOT emotional about it all! Please keep us posted on your progress.
-
Nancy Shamanna - Name: Nancy Shamanna
- Who do you know with myeloma?: Self and others too
- When were you/they diagnosed?: July 2009
Re: Auto Stem Cell Transplant Harvest - What to Expect?
Hello.
It turns out that cyclophosphamide is used to mobilize the stem cell, or "liquidize" the stem cell--so to speak. Cyclo also has an anti myeloma effect. Some people use it in their induction theraphy along with dex and Velcade, but for my Dad's case, thalidomide dex vel is better compared to cyclo dex vel.
We're on the fifth day.
Day 1: check up of heart lungs etc
Day 2: first dose of cyclo (3hrs) and 24hrs of some liquid containing 0.9% NaCl. Both administered via IV.
Day 3: second dose of Day 2.
Day 4 & 5: rest.
Tomorrow (Day 6): first injection of stem cell stimulant.
Side effects were very mild. Slightly nauseated, two diarrheas, and that's it--both happpened on Day 3.
He has done 10 cycles of induction theraphy, I hope when the Doctor extracts the stem cell on Monday, it will flow out just like a morning pee.
I'll keep you guys posted. Thanks.
It turns out that cyclophosphamide is used to mobilize the stem cell, or "liquidize" the stem cell--so to speak. Cyclo also has an anti myeloma effect. Some people use it in their induction theraphy along with dex and Velcade, but for my Dad's case, thalidomide dex vel is better compared to cyclo dex vel.
We're on the fifth day.
Day 1: check up of heart lungs etc
Day 2: first dose of cyclo (3hrs) and 24hrs of some liquid containing 0.9% NaCl. Both administered via IV.
Day 3: second dose of Day 2.
Day 4 & 5: rest.
Tomorrow (Day 6): first injection of stem cell stimulant.
Side effects were very mild. Slightly nauseated, two diarrheas, and that's it--both happpened on Day 3.
He has done 10 cycles of induction theraphy, I hope when the Doctor extracts the stem cell on Monday, it will flow out just like a morning pee.
I'll keep you guys posted. Thanks.
Re: Auto Stem Cell Transplant Harvest - What to Expect?
Mephalan is used at the actual transplant. It will not be used for the harvesting phase, because it will kill all the stem cell.
In fact, that's the idea of ASCT--induction therapy to try to minimize the cancer cells, harvest the stem cells, bomb the body with mephalan to kill all the stem cells (both good and bad), then reinfuse the good stem cells to the body, with a hope that they will grow to a more-normal cells.
In the old days, they only use mephalan. As a result, the recover may take longer.
Pardon my spelling.
In fact, that's the idea of ASCT--induction therapy to try to minimize the cancer cells, harvest the stem cells, bomb the body with mephalan to kill all the stem cells (both good and bad), then reinfuse the good stem cells to the body, with a hope that they will grow to a more-normal cells.
In the old days, they only use mephalan. As a result, the recover may take longer.
Pardon my spelling.
12 posts
• Page 1 of 2 • 1, 2
Return to Treatments & Side Effects