Emily's Journey

The following information outlines Emily’s upcoming treatment.  As mentioned in previous blogs, this treatment will include high dose chemotherapy and a stem cell transplant.

Emily will have an autologous stem cell transplant.  This means Emily’s own stem cells will be used.  They will be collected prior to the high dose chemo and then returned to her afterwards.  This approach is used to help reduce the chances of her cancer coming back (relapsing) in the future.

High-dose chemotherapy aims to destroy disease.  As an unwanted effect, it may also destroy the precious population of stem cells, which then need to be replaced.  In short, a stem cell transplant is necessary to ensure that the bone marrow is repopulated with healthy blood stem cells following high-dose treatment.  The new blood stem cells will rebuild the body’s blood and immune systems.  The recovery of these systems is vital for survival.

Stem cells are collected from the blood stream by passing all of the blood through a special machine called a blood separator or apheresis machine.  The blood is drawn from the line that was placed in Emily’s femoral vein. The machine spins the blood very quickly and removes the part that contains the blood stem cells. This is a continuous process. While the stem cells are being removed the rest of her blood is being returned to her via another port.

A peripheral blood stem cell collection usually takes 3 – 4 hours.

The stem cells will be frozen (cryopreserved) and stored until they are infused on the day of the transplant.

The day that the stem cells are transplanted is often considered as the most crucial day however, it is important to realise that the processes involved in a stem cell transplant are often long and complex. In reality a transplant involves a lot of preparation and a lot of aftercare.

Before Emily receives her transplant she will have a few days of what is known as conditioning therapy (high dose chemo). Conditioning therapy is used to help destroy any leftover cancer cells in the body and make space in the bone marrow for the new stem cells.

The transplant itself is a relatively straightforward affair. The stem cells are infused intravenously, rather like a pink-coloured blood transfusion. This can take between 30 minutes and four hours, depending on the volume of cells being infused.

After they are infused, the stem cells travel through the blood stream and find their way to the bone marrow. Here they set up home and begin to repopulate the bone marrow with families of immature white cells, platelets and red cells. This process is known as engraftment and it usually takes anywhere between 10 and 21 days.

Emily will be monitored very carefully in the early days following her transplant. This involves being examined by the doctor every day and having regular temperature, pulse and blood pressure measurements taken by the nurses. Each day, blood samples are taken from her central line to check blood counts and to monitor kidney and liver function.

Once the stem cells have engrafted, Emily’s immune system will take some time to recover to a normal level of functioning.  During this time there is still a high risk of infection.

We will continue to update the blog regularly to keep you informed of how Emily is progressing.

Leona & Vanessa