Stem Cell Collection 2

Bet you never thought there was such a thing did you? But indeed there is and this month we celebrate Plerixafor Hydrochloride This was the cunning plan of which my consultant spoke. Basically it's a really new drug which seems to have the effect of giving the stem cells we want to collect a great big boot up the backside to get them out and into the bloodstream. For whatever reason (Fludarabine being the number 1 suspect) I can't seem to mobilise enough of the little buggers to make transplantation a viable option. With Plerixafor however I was told there was a really good chance of getting what we need. It's not licensed for general use on the NHS yet but is provided to UCH by the drug company that makes it (Genzyme) on a named patient basis. As I ticked all the boxes they agreed to let me have some so that we could try again.

The protocol this time was to give me pretty nearly double the dose of G-CSF that I was having previously to give the Plerixafor something to work with. After 4 days of it I began to feel the deep down bone ache that I've always heard about with G-CSF but never experienced. It's down to the excess production in the bone marrow....as more and more cells get produced there simply isn't enough room for them all and your bones begin to struggle with the volume. You feel it particularly in the small of the back and chest (well at least I did). This was a good sign as it meant there might be something worth harvesting! On day four Nik and the kids duly dropped me off at UCH to spend the night up on the 16th floor.....the transplant ward. There's a great view of London from up there; next time I'm in I'll take a photo. I was given the Plerixafor injection at 11pm as scheduled and tried to get some sleep. (Fat chance)

Monday duly dawned (with the usual blood pressure and temperature checks at 6am. Why so bloody early?) and after breakfast it was down to the apheresis bay for another attempt. This time the call from the lab was much more heartening, a score of 0.7 - a seven-fold increase on the last effort! After another night in UCH and another day on the machine we scraped together another 0.2 which means in total I now have 1 million CD34 cells per kilo.

This is still some way short of the 2 million they originally told me we had to aim for, but 1 million apparently is still some sort of milestone because they used to transplant with this amount on a regular basis. With an extra million however it was found that the time it took the cells to engraft was shorter and therefore the period of neutropenia (and risk) somewhat less too. So what now?

Well for the last couple of weeks the lab at UCH has been growing some of the cells they collected to check their viability. They want to see if they function well enough to go ahead with just the million that we've got. I guess the other option would be to try and collect some more. But as the Plerixafor is provided by the drug company I don't know if more than one attempt using it is permitted or even safe. Also G-CSF and apheresis are both pretty expensive and quite tough on the body so I'm not sure if I'll get another shot. Lots of questions then and some answers hopefully tomorrow (Tuesday 2nd) when I see Dr D'Sa (my consultant) at UCH. Watch this space...