Wednesday, 30 April 2008

Bone Marrow Harvest

Eric has to be at the hospital for 6:45 tomorrow morning for a surgical bone marrow harvest.

The bone marrow harvest takes place in an operating room, usually under general anesthesia. It involves little risk and minimal discomfort. When the patient or donor is under anesthesia, the physician inserts a needle into the cavity of the rear hipbone, where a large quantity of bone marrow is located. Several skin punctures on each hip and multiple bone punctures are usually required to extract the requisite amount of bone marrow. There are no surgical incisions or stitches involved, only skin punctures where the needle was inserted.

( from )

Please please please let there be enough stem cells for him to be able to proceed to transplant....

Saturday, 19 April 2008

Third Time is the Charm?

We're at it again. On Monday Eric starts a new protocol to stimulate stem cell production and mobilization. He'll make daily visits to the Haematology Medical Day Care Unit to receive a drug called Stemgen. In googling this drug, most of the information is coming from Australia and New Zealand (and a bit from Canada). Leads me to believe that it is not a drug in use in the USA (thus the limited info!).

We understand that there are some allergic responses to Stemgen so they will load him up on antihistamines and he'll have to hang around and be observed after every shot. He'll also have to carry and Epipen in case of severe allergic reaction.

He'll receive 10 days worth of the Stemgen in combination with Neupogen and then we hope to collect either stem cells (via apheris) or do a surgical bone marrow harvest. He went through the pre-op processes yesterday and the surgical bone marrow harvest would be on May 1. Canadian Blood Services will then do a count and we'd know on the Friday if there are sufficient stem cells to proceed with an autologous SCT.

We are hoping and praying that this third attempt is indeed the charm. Your prayers, good vibes, positive thoughts are again requested and as always much appreciated.

Monday, 14 April 2008

Somewhat Normal...

We have been enjoying a somewhat normal life lately! Eric continues to feel well while waiting for the next 'round' -- he and Morgan have tickets to the Sens game tonight. I think we are all waiting for that team to play a good playoff game!

Had a bit of excitement last week when Eric got called in at the last minute for an appointment on Friday. Fridays are generally reserved for emergencies at the BMT clinic, so it was odd. We got there to find out that the homecare nurse who cleans and dresses his PICC line weekly had called the doctor to say his PICC was infected. Obviously with Eric's history of serious infection, the team wanted to see him immediately. We said "infection? what infection?" His PICC line looks the same as always. The doctor took one look and rolled her eyes -- it was indeed a perfectly healthy looking PICC....

Now, don't get me wrong -- it was delightful to have a doctor's appointment without any bad news... But really! Considering that I have already made about 50 trips (160 KM roundtrip) to the hospital in the first quarter of the year, we really don't need to be in there just for kicks and giggles.

The homecare nurses provide a valuable service, but the quality is inconsistent. When Eric was dehydrated and running a fever, they never bothered to report it his doctor. I hate to think that there are people completely dependent on this service who have no other source of information and support.

Tuesday, 8 April 2008

New Plans

We had a good update with the BMT team today. Eric had standard bloodwork - we didn't bother waiting for results because he is fine -- no symptoms of low counts at all. Cor, Morgan and I all accompanied Eric today. What an entourage...!

We met with Dr Bence Bruckler to go over the next steps. We are relieved that, while the search for a donor continues, they are not willing to consider an Allo transplant yet.

There is a very promising drug called AMD3100 still in clinical trials that is showing increased success in mobilizing stem cells (even among those they call "poor mobilizers"). From the linked article,
"The rates of successful CD34+ cell collection were similar for patients who previously failed chemotherapy mobilization or cytokine-only mobilization: NHL—60.3%, MM—71.4% and HD—76.5%" (Bone Marrow Transplantation (2008)).

Currently the only center in Canada enrolled in the clinical trial is in Saskatchewan. Dr Huebsch is in touch with the company to try to make this drug available to Eric. Not expecting to have to ship Eric off to Saskatchewan but, hey -- that would be doable if we had to.

We will know the full plan late next week, but we expect that Eric will start the moblization protocol (more Neupogen + the AMD3100) in a couple of weeks and apharesis collection will be scheduled April 29 - May 1.

And we have a plan B too ---- He is currently scheduled for surgery on May 1. If we have not been able to collect stem cells peripherally or if not enough are collected, they will harvest directly from his bone marrow by drilling into his hip bones.

So that gives us 2 more plans to finally get stem cells for his transplant. The great news is that Eric continues to be otherwise healthy. He feels great and there is no indication that the Hodgkins is progressing. The doctors feel that there is no rush to get to a transplant and will take the time they need to get this right. Having that time is indeed a luxury and we are very grateful.

All in all, we came out of the meeting with Dr Bence Bruckler feeling positive - she answered all our questions before we could ask them and presented a plan that we are all happy with.

Thursday, 3 April 2008

Hodgkins Research

Hello -- I know that alot of you are waiting to hear what will happen next. We are waiting too! Eric has an appointment with the BMT team in Ottawa next Tuesday, so we will know more about their recommendations then.

In the meantime, I want to thank everyone who has been in touch. Knowing that many of you have signed up to be a bone marrow donor is thrilling! I love to think that because of our tiny attempt to build awareness of the bone marrow registry that someone will have a new lease on life! Pay it forward....

I have been doing alot of reading about Hodgkins research and want to share this article with you:

MD Anderson is in Houston, Texas and they are one of the leading researchers in the field. I was very impressed by this article -- it is filled with hope for the many, many young people who are facing a completely unfair diagnosis of cancer.

You can bet that I will be asking our Ottawa team who they are consulting with in solving for Eric's situation. I am hoping that MD Anderson is mentioned. If not.... well... I happened to find today that MD Anderson has a Canadian liaison office in Toronto. I don't know yet how this would work, but we need to find a way to get Eric cured and if we need to look at options outside of Ottawa, well.... then we'll need to find a way to do that.

Finally, an important note... Eric's former boss has invited him to attend the Sens game tomorrow night -- What a terrific guy! Paul, I have never met you -- but let me say, you are a class act. If anyone wants to support a fantastic businessman in Ottawa, make sure you swing by the Subway in Carlingwood. Thanks Paul.