# Ask the Guy who is about to get a Stem Cell Transplant **URL:** \ **Category:** In My Humble Opinion\ **Created:** [January 24, 2013, 8:13pm UTC](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251 "2013-01-24T20:13:00Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Mama\_Zappa](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@Mama\_Zappa](https://boards.straightdope.com/u/Mama_Zappa)\ **Post date:** [January 25, 2013, 3:30am UTC](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251/21 "2013-01-25T03:30:33Z")
> [@USCDiver](#): > > … > Hope your MIL has a long and uneventful remission! > > The thalidomide thing is actually an issue for my wife and me. My conditioning regimen included Revlimid which is essentially a second generation analogue of Thalidomide (I was also on Dexamethasone and Velcade twice a week). Unfortunately, my wife and I were just about to try getting pregnant when I was diagnosed so that’s a big no-no while taking the Revlimid and I’ll probably end up taking it for two years after the transplant as part of my maintenance phase. Well, her M-spike is at 1.0 lately which I gather isn’t ideal. They chose the treatment regimen they did because apparently some other regimen would mean that a transplant would _not_ be feasible (I don’t recall whether they were considering auto or donor). Is Revlimid a problem for the father? I honestly don’t know - the horror stories from the 60s / 70s were when the _mother_ took it, but if it’s genetic damage that makes sense. I guess making a deposit at the sperm bank isn’t / wasn’t an option? ---
**Author:** ![PandaBear77](https://avatars.discourse-cdn.com/v4/letter/p/edb3f5/32.png) [@PandaBear77](https://boards.straightdope.com/u/PandaBear77)\ **Post date:** [January 25, 2013, 6:29am UTC](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251/22 "2013-01-25T06:29:41Z")
Bitchin’! (The transplant, not the cancer part.) Best wishes for a speedy recovery! 🙂 ---
**Author:** ![gracer](https://avatars.discourse-cdn.com/v4/letter/g/8e7dd6/32.png) [@gracer](https://boards.straightdope.com/u/gracer)\ **Post date:** [January 25, 2013, 8:49am UTC](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251/23 "2013-01-25T08:49:54Z")
> [@USCDiver](#): > > Not really, as I noted above I’ll be getting my own cells back, known as an autogenic transplant. No one else is going to want marrow cells from a patient with cancer. There are other diseases for which an allogenic transplant is more preferred (stem cells from matching donor). So if you are interested, you should register with the [National Marrow Donor Program](http://marrow.org/Home.aspx) Well not with that attitude they won’t. I’m sure you have _beautiful_ marrow cells that lots of people want 😉 Just kiddin’, thanks for the answer! And, as others have said: the future’s so awesome to live in. To infinity and beyond! (After WWII my great-grandfather’s catchphrase was “onwards to the year 2000!” He would be so thrilled to know this is possible.) I might register, it does seem like a very important thing. But then, if they needed any of _my_ beautiful marrow it would be a really huge procedure, wouldn’t it? Or not anymore? I remember a friend gave marrow to her sister when she had leukemia, years ago. It was pretty full on, as I remember. What should I expect? ---
**Author:** ![Becky2844](https://avatars.discourse-cdn.com/v4/letter/b/91b2a8/32.png) [@Becky2844](https://boards.straightdope.com/u/Becky2844)\ **Post date:** [January 25, 2013, 9:52am UTC](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251/24 "2013-01-25T09:52:03Z")
How do your modified stem cells keep those other horny little (naturally prolific) stem cells in your marrow from continuing to overdo it? What’s the trigger, or gate? Best of luck in the ensuing weeks. Take it easy, and I’m so glad you’ve got a handle on this. ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [January 25, 2013, 10:21am UTC](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251/25 "2013-01-25T10:21:12Z")
> [@gracer](#): > > I might register, it does seem like a very important thing. But then, if they needed any of _my_ beautiful marrow it would be a really huge procedure, wouldn’t it? Or not anymore? I remember a friend gave marrow to her sister when she had leukemia, years ago. It was pretty full on, as I remember. What should I expect? From what I understand, bone marrow donation isn’t exactly a walk in the park, but it’s not the horror it used to be, either. And there’s that whole saving a life thing to give you lots of warm fuzzies and grateful nurses bringing you coffee. I’ve been on the registry about 8 years without a call. So that’s 8 years of patting myself on the back without getting any needles. The registration requires just a cheek swab done by yourself in your own home, and some money to process it - I registered when some agency or another had just given them a huge donation so there was no registration fee. If my cheek swab data ever matches someone who needs a transplant, they’ll contact me and set up some further tests to make sure it’s a really cromulent match. They pay for a check up and testing and transportation if I need to go somewhere for that stuff. If I am a good match, then the doctors will figure out which method of donation is best for me and the recipient - the one \*\*USCDiver \*\*is doing now, taking medicine (also paid for by them, or by the recipient’s insurance) for 5 days to increase the right kind of cells in the blood and then collecting that blood, filtering out what they need and returning the rest, OR the ol’ needle in the hip marrow donation, which they now give the good anesthetics for so it doesn’t hurt as much as it used to. Either way and \*unlike \*what \*\*USCDiver \*\*is going through, they don’t take much and it doesn’t compromise the donor’s immune system. > [@](#): > > Q: What is the donation process like? > A: Adult donors may be asked to donate in one of two ways: > > ``` > Bone marrow donation is a surgical procedure in which liquid marrow is withdrawn from the back of the donor's pelvic bones using special, hollow needles. General or regional anesthesia is always used for this procedure, so donors feel no needle injections and no pain during marrow donation. Most donors feel some pain in their lower back for a few days afterwards. > Peripheral blood cell (PBSC) donation involves removing a donor's blood through a sterile needle in one arm. The blood is passed through a machine that separates out the cells used in transplants. The remaining blood is returned through the other arm. > > ``` ---
**Author:** ![jabiru](https://avatars.discourse-cdn.com/v4/letter/j/bbce88/32.png) [@jabiru](https://boards.straightdope.com/u/jabiru)\ **Post date:** [January 25, 2013, 1:20pm UTC](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251/26 "2013-01-25T13:20:23Z")
> [@USCDiver](#): > > My knowledge of peds oncology is pretty limited, but I could see where they’d want to avoid autologous transplants in those cases which are typically related to more undifferentiated cells (lymphoblasts) and more closely related to genetics. In my case, plasma cells are about as far down the chain as you can get so I don’t think the risk of re-colonizing myself with cancer cells is as much of a concern. I anticipate a 2-3 week stay in isolation to wait for cell counts to bounce back. My knowledge of adult oncology is severely lacking, as you can tell. Two to three weeks is great. Hope everything goes well for you. ---
**Author:** ![Mama\_Zappa](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@Mama\_Zappa](https://boards.straightdope.com/u/Mama_Zappa)\ **Post date:** [January 25, 2013, 1:53pm UTC](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251/27 "2013-01-25T13:53:45Z")
So I’ve always had the vague idea that MM is pretty close to leukemia, treated by hematologist/oncologists. The “marrow transplant” treatment option supports that impression. But then there are those lesions on the spine etc. (I assume my MIL had/has some as well, she didn’t tell us about them though). Are they actual cancerous tumors? If so, how does the stem cell procedure stop them from continuing to produce Bad Stuff? And what does the dexamethasone do anyway? I mean, I know it suppresses the immune system, but why is that beneficial in cancer treatment? ---
**Author:** ![gracer](https://avatars.discourse-cdn.com/v4/letter/g/8e7dd6/32.png) [@gracer](https://boards.straightdope.com/u/gracer)\ **Post date:** [January 25, 2013, 6:11pm UTC](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251/28 "2013-01-25T18:11:11Z")
> [@WhyNot](#): > > From what I understand, bone marrow donation isn’t exactly a walk in the park, but it’s not the horror it used to be, either. And there’s that whole saving a life thing to give you lots of warm fuzzies and grateful nurses bringing you coffee. > > I’ve been on the registry about 8 years without a call. So that’s 8 years of patting myself on the back without getting any needles. The registration requires just a cheek swab done by yourself in your own home, and some money to process it - I registered when some agency or another had just given them a huge donation so there was no registration fee. > > If my cheek swab data ever matches someone who needs a transplant, they’ll contact me and set up some further tests to make sure it’s a really cromulent match. They pay for a check up and testing and transportation if I need to go somewhere for that stuff. If I am a good match, then the doctors will figure out which method of donation is best for me and the recipient - the one \*\*USCDiver \*\*is doing now, taking medicine (also paid for by them, or by the recipient’s insurance) for 5 days to increase the right kind of cells in the blood and then collecting that blood, filtering out what they need and returning the rest, OR the ol’ needle in the hip marrow donation, which they now give the good anesthetics for so it doesn’t hurt as much as it used to. Either way and \*unlike \*what \*\*USCDiver \*\*is going through, they don’t take much and it doesn’t compromise the donor’s immune system. Thanks **WhyNot**. I am going to consider that. I have two friends who work at local hospitals, one as a nurse and one interning as a doc. I’ll ask them all the how stuff. It does sound way less invasive than what my friend had to do, IIRC she had to spend the night, and it was pretty painful. I might be misremembering though, this was years ago. Like, twenty years or something. So another yay for living in the future! ---
**Author:** ![USCDiver](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/uscdiver/32/354_2.png) [@USCDiver](https://boards.straightdope.com/u/USCDiver)\ **Post date:** [January 25, 2013, 10:04pm UTC](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251/29 "2013-01-25T22:04:10Z")
> [@Becky2844](#): > > How do your modified stem cells keep those other horny little (naturally prolific) stem cells in your marrow from continuing to overdo it? What’s the trigger, or gate? > > Best of luck in the ensuing weeks. Take it easy, and I’m so glad you’ve got a handle on this. > [@Mama\_Zappa](#): > > So I’ve always had the vague idea that MM is pretty close to leukemia, treated by hematologist/oncologists. The “marrow transplant” treatment option supports that impression. > > But then there are those lesions on the spine etc. (I assume my MIL had/has some as well, she didn’t tell us about them though). Are they actual cancerous tumors? If so, how does the stem cell procedure stop them from continuing to produce Bad Stuff? > > And what does the dexamethasone do anyway? I mean, I know it suppresses the immune system, but why is that beneficial in cancer treatment? With multiple myeloma it isn’t the stem cells that grow all crazy it is (usually) a single plasma cell that goes nuts. Plasma cells are the cells that make antibodies and each cells produces antibodies to a different antigen (bacteria, vrius, etc). When a plasma cell goes bad it divides forming a plasmacytoma and also begins to produce massive amounts of antibodies while destroying the bone around it. There is some marrow in just about every bone including the skull, ribs, vertebrae, etc to there can be lesions just about anywhere there is bone. I don’t know how or why dexamethasone helps, and I’m not sure anyone else is too sure either! The idea behind the stem cell transplant it to kill everything in the marrow, good and bad, which would normally be fatal. (See chemical warfare.) Then the stem cell transplant is just a rescue procedure. ---
**Author:** ![Becky2844](https://avatars.discourse-cdn.com/v4/letter/b/91b2a8/32.png) [@Becky2844](https://boards.straightdope.com/u/Becky2844)\ **Post date:** [January 25, 2013, 11:33pm UTC](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251/30 "2013-01-25T23:33:09Z")
Ohhhh, okay. It’s a complete “cleaning of the house” kind of thing. After reading your words “destroying the bone around it” I wanted to ask: is multiple myeloma anything like what my mother had?..I’ll try to spell it… eocenaphylicgranuloma. It ate pieces of her bone away. Does it ring a bell? It was many years ago and they did a lot of surgery on her. ---
**Author:** ![Bosda\_Di\_Chi\_of\_Tricor](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bosda_di_chi_of_tricor/32/16845_2.png) [@Bosda\_Di\_Chi\_of\_Tricor](https://boards.straightdope.com/u/Bosda_Di_Chi_of_Tricor)\ **Post date:** [January 25, 2013, 11:33pm UTC](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251/31 "2013-01-25T23:33:46Z")
Luck to you. ---
**Author:** ![Mama\_Zappa](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@Mama\_Zappa](https://boards.straightdope.com/u/Mama_Zappa)\ **Post date:** [January 25, 2013, 11:40pm UTC](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251/32 "2013-01-25T23:40:34Z")
> [@Becky2844](#): > > Ohhhh, okay. It’s a complete “cleaning of the house” kind of thing. > > After reading your words “destroying the bone around it” I wanted to ask: is multiple myeloma anything like what my mother had?..I’ll try to spell it… eocenaphylicgranuloma. It ate pieces of her bone away. Does it ring a bell? It was many years ago and they did a lot of surgery on her. Eosynophilic granuloma? A quick google turns up that this is also called histiocytosis, and I’m guessing it’s autoimmune but I (unlike the OP) have NOT been to medical school. OK, I used to live a block away from a hospital and used to cut through the building on foot a lot, but I don’t think that qualifies me :). ---
**Author:** ![Becky2844](https://avatars.discourse-cdn.com/v4/letter/b/91b2a8/32.png) [@Becky2844](https://boards.straightdope.com/u/Becky2844)\ **Post date:** [January 25, 2013, 11:48pm UTC](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251/33 "2013-01-25T23:48:29Z")
😛 But thanks for the correct spelling. ---
**Author:** ![Mean\_Mr.Mustard](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mean_mr.mustard/32/3865_2.png) [@Mean\_Mr.Mustard](https://boards.straightdope.com/u/Mean_Mr.Mustard)\ **Post date:** [January 30, 2013, 3:41am UTC](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251/34 "2013-01-30T03:41:20Z")
Hey, **USCDiver** , I just read your entire three-year-old Ask the ER Doc thread, and was ultimately steered toward this thread. My point is, I came to “know” you and appreciate you there and, as a result, I’m a bit bummed out to learn about what you are now faced with. I hope that makes sense. Anyway, just wanted to wish you all the best; you seem like a good ovum. mmm ---
**Author:** ![Ethilrist](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ethilrist/32/4604_2.png) [@Ethilrist](https://boards.straightdope.com/u/Ethilrist)\ **Post date:** [January 30, 2013, 3:58am UTC](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251/35 "2013-01-30T03:58:25Z")
You’ll let us know if you develop any super-powers, right? I mean, we can all keep a secret… ---
**Author:** ![USCDiver](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/uscdiver/32/354_2.png) [@USCDiver](https://boards.straightdope.com/u/USCDiver)\ **Post date:** [January 30, 2013, 4:13am UTC](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251/36 "2013-01-30T04:13:55Z")
Ha! Thanks guys, I’ll let you know if I suddenly learn to fly. I’m actually heading in tomorrow for Step 1: Hickman, cytoxan , fluids, nausea meds, etc for 3 days. Then my 14 day clock starts before my hair all falls out. ---
**Author:** ![Ethilrist](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ethilrist/32/4604_2.png) [@Ethilrist](https://boards.straightdope.com/u/Ethilrist)\ **Post date:** [January 30, 2013, 4:18am UTC](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251/37 "2013-01-30T04:18:44Z")
ooh! pics or it didn’t happen. ---
**Author:** ![Pazu](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pazu/32/15522_2.png) [@Pazu](https://boards.straightdope.com/u/Pazu)\ **Post date:** [January 30, 2013, 5:02am UTC](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251/38 "2013-01-30T05:02:55Z")
> [@Mama\_Zappa](#): > > Eosynophilic granuloma? A quick google turns up that this is also called histiocytosis, and I’m guessing it’s autoimmune but I (unlike the OP) have NOT been to medical school. OK, I used to live a block away from a hospital and used to cut through the building on foot a lot, but I don’t think that qualifies me :). Eosinophilia granuloma is a particular form of a condition called Langerhans cell histiocytosis, which is a neoplastic proliferation of histiocytes. Histiocytes are derived from one of the various types of white blood cells (monocytes/macrophages) and plasma cells are another (they’re actually terminally-differentiated B-lymphocytes). So you could say the two conditions are distant cousins. ---
**Author:** ![Pazu](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pazu/32/15522_2.png) [@Pazu](https://boards.straightdope.com/u/Pazu)\ **Post date:** [January 30, 2013, 5:05am UTC](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251/39 "2013-01-30T05:05:36Z")
BTW, best of luck, **USCDiver**! Yay for autologous BMTs! ---
**Author:** ![cwthree](https://avatars.discourse-cdn.com/v4/letter/c/9de0a6/32.png) [@cwthree](https://boards.straightdope.com/u/cwthree)\ **Post date:** [January 31, 2013, 4:22am UTC](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251/40 "2013-01-31T04:22:10Z")
> [@USCDiver](#): > > When a plasma cell goes bad it divides forming a plasmacytoma and also begins to produce massive amounts of antibodies while destroying the bone around it. Assuming that the transplant works, what happens to the plasmacytomas and the damaged bone? Will the body replace the missing/damaged bone, or will you have the lesions the rest of your life? I wish you the best. [Previous page](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251.md?page=1) [Next page](https://boards.straightdope.com/t/ask-the-guy-who-is-about-to-get-a-stem-cell-transplant/648251.md?page=3)