George’s Journal

It never ceases to amaze me how generous and giving people are. Cheryl and I have been blown away by the donations that have come in. Thank you from the bottom of my heart for helping our family during a challenging time. I will spend the rest of my life “paying forward” your love, care and generosity. Your messages in the Guestbook are inspiring – I reply to all ON this site. Your prayers are deeply cherished, please keep them coming!

Today’s journal will focus on my Bone Marrow Transplant protocol, and also provide you a brief tutorial on Lymphoma – a bit more scientific or technical than my typical prose.

Seven Month Journey

As pointed out in “George’s Story,” I was diagnosed with Follicular Lymphoma (small cleaves) – most common slow-growing Non-Hodgkin Lymphoma (NHL) – in November 2001. While living in the Bay Area, I was treated at Stanford U. Medical Center. We moved to Orange County in 2003. My disease was in remission from 2004 through April 2008. I transferred my health care to U. of California-Irvine Medical Center in early 2007Last summer, the cancer transformed into the aggressive, Diffused Large B Cell Lymphoma. Since September, we’ve been fighting to get to the BMT opportunity. Seven challenging months, involving 9 City of Hope, and 1 Oasis of Hope Hospital stays…but now we’re here!

Tuesday, I was admitted to the City of Hope to begin the Bone Marrow Transplant protocol – my long-awaited opportunity to be cured! There are three critical phases to the BMT: (1) Donor Matching phase, (2) Conditioning phase, and (3) Engraftment phase. No surgery. The type of BMT I’m receiving is an Allogeneic Stem Cell Transplant, from a “Matched Unrelated Donor (MUD).” The stem cells are harvested from the donor’s blood. A stem cell transplant is sometimes called a bone marrow transplant.

The Donor matching phase has already been accomplished. As much as they wanted to be, none of my four siblings were matches. Mary Beth, Suzanne, Janet and John tried their best, but meeting the matching criteria was out of their control. Fortunately, after a couple months, the City of Hope’s MUD office, found a Matched Unrelated Donor for me! The MUD was a 9 out of 10 match to my HLA (Human Lymphocyte Antigens). My donor had to pass a few health exams to ensure he was healthy enough to donate, and didn’t pose an unacceptable risk of infection to the recipient (me).

Tuesday, they started infusing me with chemotherapy for 6 days to eradicate the cancerous cells in my body this is known as the Conditioning phase. Then there will be 2 days of preparatory and precautionary medications, mostly to ward off infection, since my immune system will be non-existent for a few days. This phase will be completed 2 days before the infusion of the stem cells. In sum, we will eliminate cancerous cells, make room for new cells, and destroy my immune system. This is done to prevent rejection of the donor cells.

Hand Carry the Goods

The BMT actually takes place May 6th, my new “second birthday.” My donor is a 40-year old male living overseas. A medical center near his home, will extract his bone marrow/stem cells May 5th and a person (hopefully very dependable!) will hand carry the “product” to the City of Hope. Timing is critical. The Engraftment phase begins when I’m infused with my donor’s stem cells through a port in my right bicep area. It’s also where I receive chemo, many medications, blood transfusions, and have my blood drawn.

Stem cells are “immature cells” known as hematopoietic or blood-forming stem cells. Hematopoietic stem cells divide to form more blood-forming stem cells, or they mature into one of three types of blood cells: white blood cells, red blood cells, and platelets. The hematopoietic stem cells are found in the bone marrow, but some cells, called peripheral blood stem cells (PBSCs), are found in the bloodstream. There are other types of stem cell transplants. My BMT will be comprised of the PBSCs from my Donor.

The weeks following the BMT are critical. We want the stem cells to graft into my bone cavities and start producing white and red blood cells, and platelets. The new stem cells from my donor will reconstitute my immune system. Approximately 2 to 4 weeks after the transplant I should see signs of my bone marrow “engrafting” or beginning to grow. The first sign of this is the production of white blood cells. Platelets often take a little longer to begin developing. Once I have “engrafted” and my condition is stable, I’ll be discharged from the hospital. I pray that I will make sufficient progress to be discharged 2 to 3 weeks after the transplant!

30 Varieties of Non-Hodgkin Lymphoma

Nobody knows how I attracted Lymphoma, and that is the case with the large majority of those diagnosed with cancer. Lymphoma is a blood cancer that develops in the lymphatic system. It helps to know a little about the blood, bone marrow and the lymphatic system. Marrow is the spongy center inside of bones where blood and immune cells are made. The marrow is really two organs in one; the blood cell-forming organ and the lymphocyte-forming organ, which is part of the immune system.

Stem cells become white cells, red cells and platelets in the marrow. Then they enter the blood. Platelets prevent bleeding and form plugs that help stop bleeding after an injury. Red cells carry oxygen around the body. When the number of red cells is below normal it is called anemia, which can make you tired, pale or short of breath. White cells fight infection in the body. There are two types of white cells: germ-eating cells (neutrophils and monocytes) and lymphocytes. Lymphocytes can be B lymphocytes, T lymphocytes or natural killer cells. All of these cell types help fight infection.

The Lymphatic System is part of the body’s immune system – our defense against infection. The marrow and lymphocytes are part of the immune system. Lymphoma starts with a change to a lymphocyte cell. The change to the lymphocyte causes it to become a lymphoma cell. The lymphoma cells pile up and form lymphoma cell masses. The masses gather in the lymph nodes or other parts of the body. About 11% of people with lymphoma have Hodgkin lymphoma. The rest of us have one of the 30 or so types of NHL. Hopefully, after reading this, you’re more educated regarding BMTs and Lymphoma’s. (Click on Read Full Post – below right).

Opportunity to be Cured

While in the hospital, I’ll take it “a day at a time.” Staying positive, surrendering to the Lord, to lead me through this intense process in good shape. With excellent nursing provided by Marisa and Juana, and others, I’m very well cared for. I can see the LA skyline from my private room. I have books, DVDs and the TV for entertainment.

Going forward, May 6th will be my second birthday. My opportunity for a renewed life, cancer free! We’ve overcome many challenges to get to this point. I’m ready for this huge step. It’s gametime!

God bless you and yours,

….”With God all things are possible”. “Matthew 19:26)

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