• Lewis

Autologous Stem Cell Transplantation: A Background

Updated: Oct 12, 2020

I remember sitting in a National Five Biology Class, learning about stem cells and how they were going to "Cure the Incurable" one day - mind you I never really planned on trying it first hand...


In an earlier post, I touched upon the fact that there is two type of SCT - Autologous and Allogenic. Autologous is the use of your own cells, and Allogenic is the use of a donors cells, who could be either related or unrelated. Autologous Transplant carries significantly less risk than Allogenic transplantation.

Autologous Stem Cell Transplantation (auto-SCT) is the practice of using High Dose Chemotherapy to kill any remaining Hodgkin's cells while crippling your immune system. Before the re-introduction of your own stem cells. These stem cells then repopulate your bone marrow, creating an abundance of new blood cells - pretty much a factory reset of your immune system.

A quick plug here to join the register!! Click the Save a Life button on the top bar - it's quick, easy and all that's needed is a saliva sample. You could save someone's life. 

The process begins with the harvesting of your own stem cells - if you're not au fait with this, be sure to check out Part Twenty. Secondly, you need a remission - auto-SCT is only likely to work in around 15% of people with active disease at the time of Transplant, a remission bats the chances of "cure"to upwards of 70%.

Following these steps - you undergo an affray of tests. These tests include but are not limited to; coronavirus tests; an ultrasound of the heart; a twenty-four-hour urine sample (to check kidney function); lung function tests and an array of blood tests. 

After and not before all the steps are completed, you are admitted to the hospital to begin "conditioning therapy." Conditioning is the high dose chemotherapy, and in my case, It will be the BEAM regime. BEAM is an acronym for the drugs;

BiCNU - Carmustine 

Etoposide 

Ara-C - Cytarabine

Melphalan

You get BEAM over six days.

Day 1 

Carmustine as a drip (infusion) over 1 to 2 hours. 

Days 2, 3, 4 and 5 

Cytarabine twice a day as a drip over 30 minutes and Etoposide once a day as a drip over 2 hours.

Day 6 

Melphalan as a drip over 30 minutes with lots of fluids through a drip over several hours. 

These are scary drugs! Carmustine and Melphalan are derived from the chemical warfare agent - mustard gas. The short term side effects can be quite debilitating due to the medications and their dosage, and there is no doubt this is going to be the trickiest of the lot, but we will get through it as we have done with everything prior. 

After the chemotherapy, your stem cells are returned to you over 30 minutes - apparently a non-event. You remain in isolation and hospital until your blood counts rise above a certain level for more than two days. You have virtually no infection-fighting cells during the stay, so even a common cold could be enough to finish you off. 

I am strangely looking forward to the challenge and have a goal to be back in my own bed by the U.S. Presidential Election. Please feel free to message away, and I am more than open to any ideas you may have about passing the time!


Anyway, today is the beginning of the end. Monday 5th October 2020.


The light at the end of the tunnel is only getting bigger.