Bone Marrow Transplant

Joshua (age 6) snapped opened a chicken bone today and informed me that the gooey red/black stuff inside was bone marrow. "This," he said, "is what makes your blood." I've eaten hundreds (maybe thousands?) of chickens in my life and have never seen its bone marrow. It's pretty gross. :)

This 'goo' is what Joy will need to have transplanted. On Tuesday, one of Joy's doctor's, Dr. Peterson, sat down with all of her immediate family that was in town and held a meeting informing us all of the details of her bone marrow transplant.

Basically, having a successful transplant greatly improves her chances of recovery. Many factors go into her having a successful transplant.

1) She will have to have radiation therapy to further destroy any remaining cancer cells. She will receive radiation in several small doses. Together, these doses add up to a larger dose than is typical for radiation treatment, but the breaking down of the doses allows for her body to accept more of it in a healthier way.

2) She needs to find a bone marrow donor. Ideally, she would have what is called a 10 out of 10 match. Some transplants have been done with an 8 out of 10 match, but the better the match, the better the chance of Joy's body accepting the transplant. None of the four siblings that have been tested are matches. Her brother, Darren, has been tested and the results of the test will come in Friday or Monday. In case he is not a match, Joy's doctors have been looking at a worldwide donor list. Apparently, the chances of her finding a match in this list is greater than 85%. Already, her doctors have found 64 possible candidates. These candidates are now being tested to see if they are exact matches.

3) Once she has found a donor, it is important to determine whether or not her cancer is in remission. The transplant is smoother and more successful if this is the case. If this is not the case, she will be given another round of chemotherapy before undergoing the transplant.

4) There are two ways to obtain bone marrow from a donor. The first involves exatracting it directly from the host's pelvic bone. The host is given anesthesia and then the marrow is extracted. This is a good option if Joy's cancer is in remision because the marrow will not contain white blood cells from the host and thus there will be less of a chance of a clash with the host's immune system. The second involves giving the donor medication which induces extra bone marrow production. The marrow is then harvested from the donor's blood stream over a few days. This is the best option if the cancer is NOT in remission because the donor's white blood cells can sometimes help combat the remaining cancer cells. Although each option is best for a different scenerio, it is up to the donor which extraction method he or she prefers.

5) The transplant involves taking the donor's marrow and injecting it directly into Joy's bloodstream. Her bloodstream then takes the marrow and integrates it into her own, hopefully replacing the mutated marrow.

6) Dr. Peterson is an expert in bone marrow transplants and has overseen over 5,000 transplants in his career.

7) Because Joy is young, she will have a full transplant instead of the 'mini' transplants often received by elderly patients.

We all learned a great deal in the meeting and are very grateful for Dr. Peterson. Joy (as always) is looking beautiful in her scarf and (of course) painted toenails.