MY MS STEM CELL JOURNEY

Stem cell committee and consultant approval

After meeting my Haematology consultant Dr G, HSCT coordinator and clinical nurse’s it was off to hospital to have my first introduction to chemotherapy - a very daunting experience for those who have never experienced anything like it before. I suppose I had an advantage over many, having spent the last 6 years being infused monthly with my previous MS treatment (Tysabri). Even having a fainting moment towards the end of my initial consultation with Dr G (not a good start but later found out I was carrying a bladder infection) I was still given the go ahead for the transplant.

Pre transplant Stem cell mobilisation - Stage 1

The stay in hospital lasted 48 hours where I spent 24 hours on a slow drip containing MESNA (a drug used to protect the bladder and kidneys from the effects of chemotherapy drugs) with fluids and 3 hours on Cyclophosphamide (the chemo drug being used through my treatment and as seen above). The idea is to begin killing off some of your current stem cells forcing the bone marrow into producing new ones. The new stem cells are the ones needed for the apheresis (stem cell harvesting) in 10 days time and once cleaned will be the very stem cells transplanted back into your body.

When you leave the hospital you are packed off with a cocktail of drugs to continue helping the good stem cells to move out of the bone marrow and into the blood stream. I was given:
•Ciprofloxacin to take every day which is an antibiotic to help prevent any unwanted infections
•Ondansetron and Domperidone two different anti-sickness tablets depending on how sick you feel
•finally a drug called G-CSF (Granulocyte-colony stimulating factor) which is glycoprotein that helps to stimulate the bone marrow into producing granulocytes and stem cells releasing them into the blood stream.

The G-CSF is a tricky one especially for those who don’t like needles as its a daily subcutaneous injection into the stomach, which you will have to do yourself or get someone you trust to do it for you for the next 10 days. It doesn’t hurt really, its just a sharp scratch whilst you inject yourself into the fatty tissue around the stomach – if you are lucky enough to have some that is lol.

The side effects I found were extreme bone pain (where the bones are swelling and beginning to release stem cells into the blood), flu like symptoms, tiredness and fatigue (nothing different there from an ms point of view), fevers, hair loss (yes this will happen) and MS symptoms will worsen which they did. I am sure that there are many other possible side effects but these were the main ones that hit me the hardest.

Stem cell collection (Apheresis) - Stage 2

So day ten is what the whole process is about… Stem cell collection or apheresis. I met my apheresis specialist who introduced me to Faith. Faith is the name of the dialysis machine (as seen above) that would be taking all my blood out, spinning it about like it was at an 80’s disco before separating and collecting the stem cells and putting the blood back into me. It was quite painless although it did make me feel a little lightheaded at times which is normal and you need to keep your arm perfectly still for the entire time otherwise the cannula will pop out which isn't good.

The aim was for Faith to collect two million stem cells within the allotted 4-hour period. If this wasn’t to be possible, I would have to return the following day to resume the collection aiming for the two million mark. If the second attempt also wasn’t possible, I would have to wait for two to three months and start the whole process again. However, Faith came through on our first date and not only collected the required quantity, but went on to produce twenty four million stem cells (as seen above).

“You gotta have Faith”

The not so long wait

The final part of the apheresis is down to the clever people in the laboratory who clean the stem cells then freeze them until transplant day. Now it’s time to sit back and wait for a month until the PICC line is inserted, various chest, lung and heart scans are carried out and an admission date is decided. This for me meant a lot to arrange in a short time… cover at work, an early Christmas at home with my family, various personal admin and finance arrangements such as ensuring my life assurance and pensions were all up-to-date and my Will had been written just in case. It was relentless and something I didn’t really give much thought to prior to this process beginning.

Blog time

From then on it was blog time. I decided to journal my journey to help both with the isolation time and hope that it may be of use to anyone considering this treatment or for people wanting to understand this process a little better. I have tried to protect the privacy of all those individual members of medical staff that helped me through the journey out of respect to them as they all do this for job for one reason… the health, welfare and care of each and every patient and for that you will all remain my hero’s.

Enjoy

If you have any questions please feel free to drop me a note by getting in touch.