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Transplants Bone marrow and stem cell transplantation

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Old Sat Apr 3, 2010, 02:48 PM
Jill2008 Jill2008 is offline
Join Date: Jul 2008
Location: Redding, CA
Posts: 84
Preparative Regimen

I was told that my preparative regimen for my SCT will consist of four consecutive days of total body irradiation followed by two days of high-intensity chemo (Cytoxan), two days of rest and then the stem cells will be infused. Has anyone else had this same regimen? I have been given a list of the side effects, but thought someone out there might be able to tell me more about what to expect.
I picked up my recent CBC and my counts are up just slightly probably due to the fact that I was started on norethindrone (hormone) to stop my menstrual cycle. I have a feeling my doctor will still want to procede with the transplant due to the recent Monosomy 7 finding. He said this is "bad". Monosomy 7 is usually resistant to drug treatments and also puts me at a higher risk of developing AML. I have an appointment in two weeks for the echocardiogram, pulmonary function test and another BMB. I think they are scheduling my SCT sometime in May.
Jill, 58 y/o female dx with MDS-U June 2008, IPSS:Int. 2. Allogeneic SCT May 25, 2010. Relapsed January 2011. Started Vidaza (azacitadine) Feb. 2011; Currently on cycle #58 , IV, 5-days every six weeks. WBC 5.3, Hgb 13.0, PLT 110 (2/16/18)
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Old Sat Apr 3, 2010, 07:11 PM
squirrellypoo squirrellypoo is offline
Join Date: Nov 2008
Location: London, UK
Posts: 458
Hi Jill.

I had a totally different conditioning regime - no TBI and I had three chemo drugs that were olwer intensity so I'm afraid I can't comment much on those. I did take Norethisterone to stop my periods, though, and I took them for about 6 months post-transplant. No side effects from those at all! (You know, look for positives wherever you can!).

Don't get too stressed by all the possible side effects of everything - they're all really scary but they have to tell you everything that MIGHT happen even if the chances are low. Chances are they might not happen either!

May sounds like a long time away but it'll be here before you know it... Do they know who your donor will be? Since I see you're in CA, are you going to City of Hope for your transplant? I think there are quite a few forum members who've been there.

36/F - 1984 SAA treated with ATG [complete remission until] Oct 08 - burst blood vessels in eyes and low platelets; Jan 09 - AA & hypo-MDS; July 09 - BMT (RIC MUD PSCT) July 10 - 10k for Anthony Nolan (1yr post BMT! 53:48) Sep 10 - Wedding! I've run 5 marathons now!! (PB 3:30!)
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Old Sun Apr 4, 2010, 12:24 AM
Ruth Cuadra Ruth Cuadra is offline
Join Date: Jul 2006
Location: Los Angeles, California
Posts: 612

I had this regimen for my unrelated donor bone marrow transplant at City of Hope in 1998. My TBI was divided up into 10-minute sessions three times a day over 4 days. This was the most difficult part of the whole transplant process for me. Some people mostly breeze through it, but I was sick from the very first session to the end. Nowadays there are more effective anti-nausea drugs that help keep patients comfortable.

After the TBI, I had two days of cytoxan, which I expected to be as dreadful as the TBI, but I had no reactions at all. I had only one day of rest after the cytoxan, but it was enough for me because I wanted to get on with the show. My new bone marrow was infused the following evening. It was an amazing if somewhat anticlimatic experience. The premeds for the infusion put me to sleep but I got to hold the bags of marrow and watch the nurse hook me up.

I've posted a summary of my experience under Member Profiles that you are welcome to read. My physical experience with transplant is not so relevant anymore because improvements in technology and care are helping patients feel better during the process and recover quicker afterwards, but the feelings of confusion and fear are still the same. Feel free to ask me any questions you may have.

Where will your transplant be done?

Diagnosed AA 10/96, MDS/RA 6/98, MUD/BMT 10/6/98
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Old Sun Apr 4, 2010, 12:27 PM
Jill2008 Jill2008 is offline
Join Date: Jul 2008
Location: Redding, CA
Posts: 84
Squirleypoo and Ruth,
Thanks for your response. I will have my SCT at Stanford. My local hematologist felt this would be the best place to send me after spending 6 months trying to figure out why I had low blood counts. Even though my first cytology report showed four chromosome abormalities he said I had a vitamin B12 deficiency. Months of B12 injections did nothing and a multitude of antibody testing showed negative results. My husband finally demanded an answer and thats what took us to Stanford. The people there are wonderful and I really like my hemotologist and transplant doctor. My treatment is not decided by one doctor alone. It is discussed among the entire BMT team. I feel I will get the best care there and my parents also live within 30 miles so we didn't find a need to search any further.
I read the summary of your experience Ruth. Thank you for taking the time to document your journey. I feel a little more prepared for what lies ahead. I'm sure I will have questions that arise in the months ahead though and I appreciate that you are there to help answer them.
Happy Easter!
Jill, 58 y/o female dx with MDS-U June 2008, IPSS:Int. 2. Allogeneic SCT May 25, 2010. Relapsed January 2011. Started Vidaza (azacitadine) Feb. 2011; Currently on cycle #58 , IV, 5-days every six weeks. WBC 5.3, Hgb 13.0, PLT 110 (2/16/18)
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Old Sun Apr 4, 2010, 11:44 PM
Laura Laura is offline
Join Date: Aug 2006
Location: Minnesota
Posts: 433
Best of luck Jill. Keep us updated.

I had a transplant for AA. I had 1 day of TBI, 4 days of Cytoxan, and 4 days of Campath. I also was doing a clinic trial to see how effective this was against the current stuff. I thought it went pretty well.

Laura; dx SAA; MUD transplant June 18, 09; ITP June, 2011; fighting multiple complications/GVHD and now low counts again...
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