Decisions

I have an appointment at Duke on the 21st at 10 am to be evaluated for an autologous peripheral blood stem cell transplant. I am tempted to cancel the appointment and not think about it again. At this point in time, I just don’t want to have one. I don’t know how I’ll feel about it in the future, especially after I’ve exhausted other treatment regimens. I especially don’t know how I’ll feel if I find out I have not responded to thalidomide and dexamethasone or if my disease has progressed.

There are many MM patients who have had not just one SCT, but 2 or even 3. It’s a very aggressive treatment. There’s no way to know how one will respond. If there’s a remission, no way to predict how long it will last.

When I see the people at Duke on the 21st, I’ll have them send kits to each of my siblings to have their blood tested to see if any of them is a 6/6 HLA match for me. They all know about this and have all agreed to be donors if necessary. Statistically, 1 in 4 siblings will be a match. I happen to have 4 siblings. It would be SO nice to have an identical twin. I have a fraternal twin, which is no different than a regular sibling.

Human Leukocyte Antigens (HLA): A series of antigens found on white blood cells and most other cells of the body that are used to determine tissue type. Your HLA allows your immune system to recognize self from non-self. When these proteins are the same for both donor and recipient, an allogeneic stem cell transplant is much more likely to be successful. In stem cell transplantation, the HLA antigens routinely typed for are HLA-A, B, and DR.

My understanding is that the donation process is not really painful. It’s time-consuming and there would be some discomfort involved. Needles in both arms, blood going out through one and back in through the other.

Anyway, I am going to keep my appointment at Duke and get as much information as I can. I will probably have to have a SCT one day, although I’m not planning on it right away (within the next year).