Wednesday, December 15, 2010

Cloning Myself

alright fine, it's not really a clone of me, but it's a clone of my blood system!

Let me explain...

On my 21st birthday I did what all 21 year olds do, went to a bone marrow donor drive with my mom and signed up for the DKMS registry. (DKMS is the largest bone marrow donor center in the world, recruiting donors for leukemia patients) Then I went out for delicious sushi and drinks, of course. Shortly after I had completely forgotten about signing up for the registry.

That was, until this past September when I received an email, which I almost deleted thinking it was spam, saying that I was a match for a patient. Since then I have been getting blood drawn and tests done to make sure I am a full match and that I don't have any pressing health issues of my own. There is a <1% chance of finding a match if the patient doesn't have a match in their family. Turns out I am that <1% for a 3 year old little girl with leukemia.

There are currently two ways to donate bone marrow. The way most people are familiar with is the actual extraction of the stem cells from the bone marrow. The way that the patient's doctors requested I donate is the other way, through a process called apherisis. For the past four days I have been on a drug called nupogen to exponentially increase my stem cell count in my body. The goal of the drug is to increase the stem cells so much that they come out of the bone marrow and into the blood stream. In order to donate they take my stem cells out of my blood stream through IVs.

Today was donation day so Mom and I woke up well before the crack of dawn to make it into the city for my 7am appointment. Ironically, the girl who took my vitals first was someone I went to high school with, how nice to see a familiar face! There was a little bit of trouble with the first IV because my blood clotted and it wasn't coming out at a high enough pressure. So here we are, all set up, main IV in my right arm, small IV in my left wrist, and it's not working. Bummer, especially since I hate needles! I was pretty upset and nervous that they would not be able to get a good line, and I didn't know what this meant for my ability to donate. Thankfully attempt two was successful and they switched the main IV to my left arm and the small one in my right hand. I wouldn't have made it through that part without my momma there to hold my hand! We were reminiscing about how I used to freak out when I got shots and how once I almost made my pediatrician stick herself with the shot!

The process is actually really cool. Blood is drawn from one arm and goes into a machine which collects my stem cells and then the blood is put back into my other arm. The process goes through all of the blood in my body twice until the machine reaches the amount it needs. Since I am donating to a toddler who doesn't weigh very much the process only took about 4.5 hours. If it were an adult patient it could have taken 9 hours over two days! The only real pain (besides bone aching and a headache from the injections for a few days) was in my arm where the IV was. Not surprisingly, once the nurse gave me some oxycodone I was fine :). Mom and I watched a movie on my computer and chatted to pass the time.

Now, you may be wondering how this works on the patient's end. Here is where the "cloning" comes in. The patient's immune system is destroyed, to put it simply, because of the cancer cells in her body. At this point nothing else has worked treatment wise and the patient needs a bone marrow transplant to replace the cells within her bone marrow. The patient goes through more intense rounds of chemotherapy and/or radiation in order to completely wipe out her immune system and get rid of all of her stem cells. (If you are confused, stem cells are held within the bone marrow and differentiate into white blood cells, red blood cells, and platelets.) The patient receives a transplant of my stem cells (and therefore, building blocks for red blood cells, white blood cells, and platelets). We pray that her body does not reject the foreign blood and that it takes it on as it's own. Within a couple weeks my stem cells in the patient's body will hopefully have made their way into the bone marrow and act as they should, turning into white blood cells, red blood cells, and platelets. In this way the patient forms an entire new (a "clone" of my) blood system in her body. She will have my immune system, which will be cancer free.

There are a lot of things that can go wrong with the patient before she even receives the transplant (when she has no immune system) as well as after the transplant. In my case the little girl will not have the transplant until January but since I am moving I donated today and they are freezing the cells. My contact with the patient is based on her family's desire (since she is three) and limited for a long time until it is sure that the transplant has worked. I can write to the family to tell them about how the process went for me but they cannot know specifics about me such as where I am from, as I cannot know specific information about them. I think that contact can increase as the patient's chance of survival increases, and after a year I think I have a chance to meet the family, and if they so choose, the patient.

It has been a long day and if I hope to make it to work tomorrow I need to go to bed. I hope I sleep better than last night, I think I was nervous because I spent half the night awake which, some of you may know, is extremely unlike me. I will continue to update about the transplant as I receive more information.

1 comment: