medical

Step-by-Step Procedures for a MUD BMT

The purpose of this journal to capture everything involved in the process of receiving a matched unrelated donor bone marrow transplant (MUD BMT). I will describe procedures when they are not self-evident. Click HERE to first get a primer on what a BMT is all about.

My sister, Sara, is tested to see if her bone marrow matches my bone marrow. A small blood sample is all that is required. The results show she is not compatible.

My two brothers, Scott and Pat, are tested for bone marrow compatibility. Neither match my bone marrow.

A preliminary search of the National Marrow Donor Program (NMDP) database is performed at Wilford Hall Air Force Medical Center to see how many unrelated donors match my bone marrow in case I ever need a BMT. The search reveals 13 possible matches.

The above three test/searches were performed only as a precaution in case I ever needed a bone marrow transplant. I chose to go the "chemo only" route to try and rid my body of the leukemia. After one induction and three rounds of consolidation chemotherapy, I stayed in remission until Mar 02. From that point on all efforts turned toward getting me back in remission so I could receive a MUD BMT. After a single round of chemo I was back in remission. I then took a second round of chemo to keep me in remission as I progressed toward the BMT

Nancy is tested to see if she even comes close to matching my bone marrow. If she matches at least 3/6 HLAs, they will test my children for 6/6 matches. It turns out she doesn't match me 3/6.

The "Hutch" (Fred Hutchinson Cancer Research Center) in Seattle, WA has been performing the "official" search of the NMDP. They told me today that I have over 1000 possible matches for my transplant.

My mother is HLA typed to help narrow down my HLA typing. They like to see the mother and father's HLA wen possible. Since my father is dead, they only saw my mother's.

They narrow the search down to 13 perfect matches (the same number Wilford Hall said I had last year). From those 13, they have chosen a 22 year old male with B positive blood type and a 23 year old male with O positive blood type. Both are CMV negative (like me). They chose the 23 year old because I have O negative blood and it will be more compatible with the donor's O positive blood.

My donor has agreed to donate. He also has decided to donate Stem Cells instead of Bone Marrow. The preliminary date of 29 Aug 02 has been set for the transplant.

We arrive in Seattle (the entire family) to begin the transplant procedures. The transplant will be performed at the Puget Sound VA Center.

The format of the journal will now change and become a day-by-day time journal of the entire BMT process. at the Puget Sound VA Center Marrow Transplant Unit (MTU).

-Lab Testing at MTU - 30 vials of blood drawn for HIV/CMV/Hepatitis/CBC/Chem/etc.

- Other testing for Staph/RSV/Creatine/24 hour urinalysis

-Radiology for chest x-rays to baseline my lung health

-Cardio Clinic for an EKG to baseline my heart health

-Meeting at MTU with doctors/social worker/transplant coordinator to sign releases and get a BMT overview

-Meeting with social worker in his office about my finances and family situation

-Meeting with psychologist in her office about my mental awareness of the BMT process

-Turn in 24 hour urinalysis at MTU

-Radiology for CT Scan of chest to base line my lung health.

-Pulmonary function test to baseline my lung functions.

-Met with doctor at MTU to discuss my medical history

-MTU for physical exam

-Dental clinic for dental exam to baseline my dental health

-Psychologist office for cognitive test to baseline my mental functions. To be tested again in one year.

-NUCMED for bone density measurement and MRI of heart for baseline. They injected phosphates in my arm for the bone density and then drew blood, mixed it with radio active material and then re-injected it into me for the heart MRI.

-Inserted arm IV at MTU for Hickman insertion procedure.

-Hickman insertion procedure date changed to 14 Aug 02.

-Received results of cognitive test from psychologist. All is well.

-Eye Clinic to see the ophthalmologist to baseline the health of my eyes. They do all the standard checks and dilate my eyes

-Received preliminary results of bone marrow biopsy. All is well.

-Radiology Special Procedures Room to have Hickman catheter inserted into right side of my chest. I was given a mild sedative and a local anesthesia. Entire procedure takes a little over an hour.

-MTU to have Hickman bandages changed and labs drawn (CBC and Chem).

-MTU tor Nancy and me to receive training on taking care of a Hickman Catheter. They do it differently than the Air Force Hospitals.

-Labs drawn at MTU for CBC and Chem

-MTU for Nancy to show she can change my Hickman dressing without supervision from the nurses. She passed.

-Labs drawn at MTU for CBC and Chem

-Radiology Clinic for consultation on Total Body Irradiation (TBI). I was also measured to see how much radiation I will require and tattooed with marks on my chest and back to help them line up the x-ray machine when the TBI starts next week.

-MTU to meet with dietician about what kinds of foods I like and dislike. Discussed what I should be eating over the next 3 months.

No appointments today!

-Radiology Clinic to see if the lung shields they build for my TBI fit. They fit perfectly.

-MTU to pick up medications. They have started me on Bactrim (Sulfamethoxazole (800mg) and Trimeth (160mg)). I am to take them twice a day for five days to prevent pneumocystis carinii pneumonia (PCP).

-MTU for BMT conference with doctors and social worker. This was the big meeting where they tell you all the bad things that can happen and then you sign the consents

-Checked into the MTU for the transplant

This is the end of this journal. It was meant to show the preparation need to get into a tranplant. My daily journals will tell the story of actually getting the transplant.