In September 2015, after three months of induction with Revlimid ^[1] (lena­lidomide), Velcade ^[2] (bortezomib), and dexamethasone ^[3] (Decadron), my IgA heavy chain M-spike had fallen from 6.5 g/dL (65 g/L) to zero. My doctor felt that the time was right to get onto the next phase of treatment – a stem cell transplant.

I remember being apprehensive, but actually quite excited at the same time, as this procedure seemed to be the door to a real chance of re­mission and – with luck – many years of good health ahead.

I had the conditioning treatment with cyclophosphamide ^[4] (Cytoxan) for two days and then several days of blood tests to monitor the white blood cell count. The doctor had explained to me that my white count would drop down very low after the conditioning treatment. When it started to rise again, that would be the optimum time to harvest the stem cells. The target was to collect around five million cells per kilogram of body weight.

Everything was going to plan during the conditioning treatment. When my white count dropped like a stone, I was admitted into the hospital and a few days later the harvesting began.

I am sure the story which I describe is one that many of you are very familiar with. I arrived early each morning to be attached to an amazing machine for stem cell collection. Somehow my blood went in and out in all the complex tubing, but my stem cells stayed in a precious little bag at the side of the magic machine. In the particular hospital I was in, the result of the number of harvested stem cells was available at noon the following day.

So on Day 2, the Day 1 results arrived. Day 1 had not been a great success – I had only produced around 0.1 million stem cells.

The doctor and nurses remained optimistic and said that a low yield sometimes happens, and that the following day would be better.

But the Day 2 results were also very poor and, of course, it was now Day 3.

I could feel that the optimistic mood was changing and that ‘what if’ questions were looming.

So when on Day 3 results were only slightly better than Day 2, my husband Graham and I started to be very concerned. Three days of harvesting had produced less than one million cells, and we had a target of five million. I had thought that the machine and I would have parted company by now, and I couldn’t imagine what was coming next.

I will not forget the evening of Day 4. I was in the hospital bed and the doctor and the nurses arrived. Everyone looked glum and we went through all the results for the first three days and the projected figures for Day 4. I felt awful, as if I had let everyone down.

I can vividly remember feeling that I ought to apologize for being such a poor harvester! However, rather than apologizing, in an attempt to relieve the atmosphere in the room, I said that this situation reminded me of another thing I had been really, really bad at when I was young: the school long jump! And I proceeded to share my story.

When I was a teenager growing up in Scotland, I attended a rather old-fashioned convent school. Every year there was a competition amongst the school houses, with various trophies and cups to be won. Sports were part of the competition, and in the summer, this meant athletics.

I was not really built for the athletics field. I think you would call my build small and stocky! However, in each event, points were awarded just for entering the event, so I decided to enter all the events. That was quite a challenge for me, and I was last in most events. However, I remember that my participation did encourage many other non-athletic girls to have a go.

The final event was the long jump. I do recall thinking that participating in the long jump was perhaps not one of my better ideas. I nevertheless did my best. Unfortunately, my best was not good enough to even reach the sand!

As you can imagine, there was much hilarity, and I became ‘famous’ as holding a unique school record for “the only girl to do long jump and not reach the sand.” The consensus was that I had found something which I was really bad at.

When I told this story in the clinic, everyone laughed, and the atmosphere improved.

The discussion then turned to medication that could be given to boost the stem cell harvest. There was consensus among my doctors that I might benefit from taking such medication, so that evening I received Mozobil ^[5] (plerixafor) to boost my stem cell yield.

As if by magic on Day 5 and Day 6, my “performance” improved – I had good stem cell yields and almost reached the five million target.

Those were six long, tough days. Due to the poor stem cell yields at the beginning of collection, I was machine bound for almost 10 hours each day. One long-suffering, delightful nurse stayed with me all day and every day throughout the process. We became quite close, both literally and as partners in the quest. I think this nurse was as happy as I was when I achieved the goal of almost five million stem cells.

I was now set for the next step in my treatment, the stem cell transplant.  So in the end I was not so very bad at stem cell harvesting. However, I fear my long jump record will remain intact!