6 Million cd34 cells
Good morning / afternoon everyone.
Although Chiane is home, we have a long list of things to do on a daily basis. We still do her physio exercises. Her muscles are getting looser than what they were, but her feet and legs are still “not satisfactory” and we have to get it loose, because the 2nd chemo she received (vincristine) caused it… She will receive vincristine again (two more time in the next month) and her muscles will go even tighter… it is very important that we get her feet and leg muscles as loose as possible, otherwise she will end up in casts to stretch her muscles and we do not want that to happen.
Although Chiane is home for a week, there is a purpose for that. The next step is stem cell harvesting. Chiane will be submitted next Sunday (07.08.11). On Monday morning (08.08.11) she will undergo general anaesthetics and they will install a “vascath”. A vascath is almost like a cannula and it will be installed close to groin area in her thigh. She will then start CD34 cell harvesting on Tuesday (09/08/11) for 2 days (Tuesday and Wednesday). They need in total 6 Million “CD34” cells. What is cd34 cells? CD34 cells make/build bone marrow and CD34 cells also become stem cells (as you know stem cells becomes red cells/ White cells / neutrophils and platelets). Why do they harvest cd34 cells and not the stem cells itself? Because the bone marrow produces CD34 cells and stem cells do not build the bone marrow…CD34 cells do. It’s no good they harvest stem cells…
She will be connected to machine that will pump the blood out of her body, through a machine and back in to her body for 2 days, harvesting her CD34 cells. What happens if they do not get 6 million, but only 4 million for example? They have a second window 2 weeks from now to do the whole process again. That will be the last chance to harvest the rest if they are short of 6 million CD34 cells. After that there will be no more opportunities to harvest CD34 cells because the next chemo, after the 2nd window, will wipe out the last bit that is still left in her blood…why don’t they harvest the cells before chemo start? Because they don’t want to take any risks with “potential” cancer cells in her blood system… Yes they have tested her blood but there are billions of cells in her blood, there might be a few floating about… The first 3 chemos she received so far would have wiped out any cancer cells that might be floating around. The CD34 cells they will harvest now, they know for sure are “clinically clean from any ‘odd’ cancer cells that might be floating about”. Why don’t continue harvesting during this window period until they have 6 million cells? It’s all to do with timing! They HAVE to start harvesting at a certain count and 2 days later the CD34 cells will be “too mature to harvest” because they will turn into stem cells then… Timing is critical and the window to harvest it is only 48 hours.
So what happens this week? Although Chiane’s bone marrow is wiped out at the moment due to the chemo, she still has a low count of CD34 cells in her body. They boost the cells to reproduce by injecting a hormone called “G-CSF” (Granulocyte Colony Stimulation factor). This injection increases her cells to reproduce in a very short period of time, an abnormal high count of CD34 cells…we give the injection every morning at home through a small cannula that they inserted just below the skin (not in a vein) yesterday in the hospital. Why can’t we give it to her in her main Hickman lines? They found through past studies the G-CSF injections are more effective if they are injected into the tissue, and not in the blood directly. Her Hickmans are connected to her main arteries close to her heart so it’s no good for the G-CSF injection. The small cannula is under her skin in her tissue. So we do not inject her with a needle in to her skin, the needle is inserted into a small tube…she receives one a day at home in the morning, and every day a nurse comes to our house in the afternoon to draw blood through her Hickman lines. The blood goes to a lab and every day they call us and we record it in her book. By next Sunday her cell count must be above a certain level for them to start cell harvesting on Tuesday (09/08/11). What happens if her cell count is not high enough? Then they delay it until it is good to start cell harvesting.
Chiane is coming home this week to rest and to “rebuild” her cells to a abnormal high level of CD34 cells. The following week (starting 08/08/11) they will be harvesting her cells, the week after (starting 15/08/11) we’ll start chemo 4 (cyclophosphamide) and chemo 2 (vincristine again).
Hope that was “simplified” enough for everyone to understand.
Thank you all for the emails we have received! Thank you all for continuing to pray for Chiane. Xxxxxxx