Apheresis non Rapidium

Laure making a generous donation

Since Friday, our main focus has been the stem cell collection process, of which Laure is the star.  She has her "own" doc in the transplant clinic, a gentleman of German extraction named Dr. Korbling.  The process is called apheresis.  So my little joke in the title of today's post indicates that the process is not moving along at a rapid pace.  It normally takes 1-3 days to collect the needed stem cells, but it looks like we will be at it for several more days and likely into next week.

The process begins with Laure getting shots of a drug called Nupagen, which causes the bone marrow to push stem cells out into the bloodstream.  After 3 days of Nupagen shots, the first collection is done;  for us that was Monday.  The goal is 3 to 4 million stem cells per kg of bodyweight (of the recipient), and the first day produced only 300,000 cells per kg.  Laure was back in there on Tuesday afternoon and they got another 600,000 cells......so we still have at least 2 million cells to go - the docs remain confident that it's just a matter of time.  There is another regulating factor - each time they collect, platelets are also collected (the technology cannot remove all platelets from the collected stem cells) and therefore reduced - if the donor's platelet count goes below 70,000, we have to pause and let her counts come back up - so today is one of those days where we are waiting for Laure to gin up some more platelets.  The next several days will be a combination of more shots, more collections, and some resting/waiting for platelet counts to come back up......

My transplant therefore will not happen on the schedule I spoke of on Friday; as I may have said before, they will not admit me to the hospital (and therefore start chemo) until we get to 3 million stem cells per kg from Laure - our best guess is that we may move everything out a week, but it's impossible to know for sure. 

The apheresis process involves establishing a blood circuit where blood comes out on an IV in one arm, goes through a machine (centrifuge) that separates and stores the stem cells, then sends the blood back into the body via another IV in the opposite arm - during the course of a 4 hour procedure, all of Laure's blood goes through the machine 3 times.  At any given moment, there is about a cup of blood out of her body (tubes, machine, etc).

Obviously we are all a little frustrated and impatient, but trying to give this all to God and continue to trust Him, and look for the little blessings that He continues to shower us with.  And of course the BIG blessings,  like we had on Friday.  Another big blessing is that I continue to feel great and have been able to work out every day I've been here except one.

Prayer needs are for Laure's Nupagen shots to "kick in" and start cranking out stem cells- it's possible that we could get through this in one more collection, i.e., have a surge in production.  Also, that Laure's platelets would replenish rapidly.  Thanks everyone for your continued care, concern, love, and prayers.

Dan, Renee, and Laure