Here is a quick summary of the harvesting stem cell process:
Step 1:Insertion of a VERY uncomfortable catheter!
This catheter goes into your internal jugular vein in your neck and is threaded to your heart! It’s not fun to have but it makes it easier to have blood draws, infusions, and is also needed for collection of your stem cells.
Step 2: Cyclophosphamide (cytoxan) infusion.
Cytoxan is used to help mobilize stem cells to the periphery. This infusion is a whole day process.
So the chemotherapy was only a 2 hour infusion of cytoxan
But I got 6-7 L of fluids and other meds, including:
-Mesna- given to protect your bladder! The chemo can cause hemorrhagic cystitis (bleeding from bladder)
-Emend- Helps prevent nausea and vomiting
-zofran- another anti-nausea med
-dexamethasone- steroids!!
Step 3- Neupogen injections
Now for one week you are injecting yourself with neupogen (granulocyte colony stimulating factor). This is to help your bone marrow produce new stem cells. The problem is when they start making more cells, your bones hurt like crazy.
Things that help:
-Tylenol (acetaminophen)
-Claritin (loratidine)
Step 4- The Effects of the chemo
After about 1 week from receiving the Cytoxan, you start feeling all the horrible effects.
These include:
1. Fatigue- You think MS causes fatigue, haha well so does chemo! But don’t fight it, let your body rest and sleep whenever it can!
2. Neutropenia- My white blood cells reached an ultimate low of 0.2. What does this mean? Basically, any little germ comes near me, and I get sick! 🤕 They gave me Acyclovir and Ciprofloxacin to prevent infections!
Precautions:
-Take your temperature twice a day
-COVID actually helps. Social distancing, Hand washing, and masks are the way to go 😷
-Food- I pretended I was traveling internationally. Drink only bottled water, eat only COOKED food, avoid fruits, avoid baked goods! Hehe except I really needed cookies so I just warmed them up well! 😀
3. Thrombocytopenia- This means I am at high risk for bleeding!🩸 So NO falls! This is a very hard concept for MS people, but use a walker and don’t try to do anything adventurous
Falling is SUPER dangerous and you can bleed to death! So I repeat, NO FALLS
My platelets got as low as 10, so I ended up getting a transfusion!
4. Cystitis- Cytoxan (cyclophosphamide, the chemo drug) can irritate the bladder. So you feel like peeing all the time, and have urgency. Now you’d think that it’s okay, just run to the bathroom… BUT REMEMBER you have fatigue and you CANNOT fall, hehe this complicates things… DIAPERS now become your new best friend 😀
5. Nausea/Vomiting- I was lucky and didn’t have any. For those of you who know me, I’m a skinny little girl who thinks about food CONSTANTLY! So I took Zofran twice a day, just to prevent any nausea or anything from me getting foods. 😀
Step 5: Collection of stem cells
So now the last step is collecting your stem cells! We would see if all the work I put in the past 2 weeks (chemotherapy and GCSF injections) would culminate in a successful harvesting of stem cells. To pass the test I had to collect 5 million stem cells.
So I was connected to an apharesis machine! And the test began!
The apharesis machine pulls blood 🩸 from my veins through one tube , centrifuges it, keeps the stem cell layer in a bag, and then sends the rest of the blood to my body through the other tube! It’s a very complicated machine…
The machine uses citrate so your blood doesn’t clog up but this can make you hypocalcemic (have low calcium). When you have this, you can feel numbness, tingling, funny feeling around your mouth- BUT they give you calcium during this time…so I didn’t feel weird!
After 4 hours I got to go home and wait for my results! 🤔
The results came back: I COLLECTED 24 MILLION STEM CELLS!