Transplant team Meeting!!

OK, this is it! We had a meeting with the transplant team and it was a information overload so i will try my best to relay all the details that were outlined.

Why transplant-
A bone Marrow transplant is necessary as Brody is at a very high risk with his cancer (leukaemia), which means that normal chemo will not destroy his cancer. He will need very high doses of chemo and radiation to destroy all cancer cells in the body. However the high doses can also destroy Brody's own normal bone marrow cells. We need these bone marrow cells to make the blood and immune cells in our bodies, without them we could not survive.

Using the high doses then giving a transplant to replace destroyed normal blood and immune cells, allows doctors to treat cancer(Leukaemia) more effectively.

Allogeneic Transplant-
In this type of transplant, stem cells come from a donor- someone other than the patient. Which will be Brody's older brother Luke.
Allogeneic transplants are more complicated because the stem cells have come from another person and so are recognised by the body as different or foregin.
Two consequences can occur are -
Brody's immune system may attack and destroy the transplant cells (graft rejection)
The immune cells from Luke may recognise Brody's organs (skin, gut, liver, etc) as foreign and attack them. Its called graft-versus-host disease. If severe, this can be life threatening.

Therefore this is why it has been very important to make sure LUke is matched closely to Brody. I cant believe that Luke was matched so closely as he is a half brother. Must mean they both have more of me in them both.

Preparing for Transplant-
As you know Brody has had and will be having several test to assess his health. He has had Lung, eye test, heart, teeth, and hearing. Tomorrow he will be having a Ct scan of his chest plus another bone marrow test and a kidney test next week.

Conditioning Treatment-
On the 5th July he will start having radiation of his head, which he will go in once a day for treatment.
Then starting the week of the 13th he will be admitted into hospital to have radiation twice a day for 3 days.
Then he will also have the high doses of chemo, which all will help to destroy the bone marrow and cancer cells and make room for the new cells.
During this time one of the chemos given means Brody will have to have a shower 4 times a day, which is going to mean hell. As it hard to shower or bath him at home, and nearly impossible to shower him at hospital. Grrrr......

Tranplant-
The date is set for Brody's Birthday on the 21st JUly, what a present!!!! Luke's cells are put into Brody's cords the same way as a blood transfusion. Its not much, but its the after effects we have to worry about.
Luke is the one that will be in pain on the day as he is put under and stabbed several hundred times to get the bone marrow out of his lower back. Ouch!!!

Engraftment-
means new cell growth. The first two to four weeks after transplant are critical. Which means he is very susceptible to infection and bleeding. He will have meds and more transfusions to help deal with this.
New growth takes place when after the transplant when there is a sustained rise in new blood cell production.

Effects-
The main effects are increased risk of infection, bleeding, nausea, vomiting, fatigue, mouth sores, weight loss, hair loss, Diarrhoea, Pain and skin reactions.
Long term effects, fertility, complications in the liver, kidneys, lungs, joints, heart, learning and child development and long term effects also from the radiation that i said before in the meeting with the radiation team.
Also as i mention before the Graft-versus-host disease.
They have told me he could be spending time in ICU and 10 % of children that have transplant do not make it through!!! The cancer can also come back and might need other things to help him, such as another transplant.

During-
During this time, Brody will be in an isolation room, we can not have any visitors and everything needs to be cleaned each day. I can not take a suitcase or have anything on the floor. His poster will have to be laminated so that they can be wiped down. No food is to be brought in and toys and things have to be washed before entry. He can take his teddy but no other soft toys, no flowers and basically nothing can be taking in.

Home-
They can not tell us what will happen after as it depends on Brody's health. But we are looking at after 8 weeks we can come back to grandma's but still be in isolation and then have daily to weekly visits and then monthly to once a year visits.
Brody will not be able to start school about 6 months after transplant and even then will still have to be careful, as he will not have an immunisation and cant get infections. There is still alot to happen after transplant and will be a long hard road.