Stem Cell Collection
The stem cells collection was a bit bumpy:
It started with an Endoxan (cyclophosphamide) chemo. Not very pleasant, and very tiring after.
Then she had a double shot of Zarzio 30 every day for 10 days [Zarzio is a Neupogen biosimilar].
After 6 days she started to have strong fever. Blood tests showed her WBC close to 0 due to the cyclophosphamide and growth factor not yet kicking in. She was admitted to the hospital and started antibiotic treatment to fight a growing infection. Her WBC started to rise at day 7-8. Collection was done at day 10. her WBC went from almost 0 to 20k in 2 days!
During collection she had some fever and developed huge skin lesions. Doctors where a bit panicked by the lesions and fever, both being potential sign of remaining infection. Stem cells should be free of infection, otherwise during transplant it could be very dangerous. That was very bad news as my wife definition didn't want to do this all over again!
She was taken in emergency to a dermatology specialist the next day. They diagnosed Sweet's syndrome (you can google for pictures). Sweet's syndrome happens when white blood cells start to accumulate in the skin and form huge lesions.The good news was that it wasn't infectious and that it always comes with fever. They ran further tests to confirm that no infection gene can be found in the stem cells collected and the results were good.
After more than a week at the hospital she finally could get out and get ready for the stem cell transplant that was initially planned 2 weeks after.
Stem Cell Transplant
The stem cell transplant process started on August 14th with melphalan. She did chew some ice, thanks to all of your recommendations. This is apparently not something popular in our hospital in France. It seems that it did the trick as she had no mucositis nor mouth ulcers.
August 16th she had the transplant. Since day 1 she was inpatient at the hospital. During the first week she was feeling tired but was rather fine.
Second week all WBC went down to 0 as expected and they started the growth factors. She developed rather strong diarrhea and could not eat anything. Initially she was fed over night through the nose, but she could not really stand it, and ultimately she was fed through the central port.
WBC did start to raise up at day 11 after transplant. She was allowed to get out of the hospital on August 31. So she stayed 17 days at the hospita,l which around here is bellow the norm (minimum 3 weeks)
She has been very tired since but recovering a bit more every day. We are trying to maintain a minimum of 30 minutes walking every day and being very cautious so that she doesn't catch anything. Kids are back to school and unfortunately especially the youngest one tends to get sick rather often during winter (we are boosting them with vitamins now)
Growth factors did brought back Sweet's syndrome (less severe this time)
Overall I would say that this wasn't a fun part, but that beside obvious fatigue and major diarrhea for a few days, things went rather well for the transplant.
Here WBCs are climbing but neutrophil level remains low when she doesn't have growth factors.
Bellow you can see a chart summing up her WBC (leukocytes) over this journey
Thanks for all of your support and advice.
- WBC during stem cells collection and ASCT
- LouiseRoseWBCv1.jpg (51.06 KiB) Viewed 666 times
