Sunday, 27 July 2008

So, What Is Happening?

Over the past couple of months, there has been considerable testing of both Eric and his donor. The BMT team needs to know as much as possible about both so that they can orchestrate the transplant in such a way that Eric's body will accept the new marrow. Fortunately, we have a perfect match. A transplant using a matched unrelated donor is often referred to as a MUD transplant.

Eric is currently healthy -- his Hodgkins Lymphoma is as reduced as the doctor's can possibly tell. Eric's Hodgkins does not present with palpable lumps or any outward signal that it has returned. He has a couple of nodes in his abdomen that enlarge slightly (by millimeters) and then the Hodgkins seems to go right to his bone marrow. So the first indication of further relapse is low blood counts or weight loss. Currently those nodes are stable, his blood counts are high and he is at a great weight. All good signs to proceed to a transplant.

Eric will have what is called a mini or allo-lite or RIC (reduced intensity conditioning) Allogeneic transplant (or if you are googling it -- nonmyeloablative allogeneic stem cell transplant). The reduced intensity conditioning chemo reduces some of the risk around an allo transplant. Allo transplants are seldom utilized for Hodgkins due to this risk. There are no studies to support the suspicion that a mini-allo can exploit the host vs lymphoma effect -- meaning that the engrafted donor's marrow can fight any lingering Hodgkins cells.

No studies, does not mean it is not happening! Obviously, the risk around this procedure precludes random blind trials. What we know is that Eric is an excellent candidate, the match is great and we are working with the best team I could imagine.

Click to enlarge this diagram:

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