So, more info about my transplant, as I'm trying to give my friends and family as much info as possible. I figure between here and Facebook, I should have everything more or less covered, heh.
Anyway, so! The transplant. What can go wrong? A lot of things. When you're matched with a donor, you may have a difference of genetic markers on any different level--it could be at the A marker, B marker, C, D, and so forth. A mismatch at the C or D level isn't so serious, but a mismatch at A is.
Guess where my mismatch is?
Yup, A!
So what does this mean? I'm at higher risk for GVHD. GVHD stands for Graft Versus Host Disease, and is pretty much exactly what it sounds like--when the graft (the new stem cells) attack the host. There are 2 kinds of GVHD; chronic and acute.
Acute is the more dangerous one, and can appear anytime after your transplant--anytime from within the first month to any point later in life! That being said, the most common time for acute GVHD to occur is within the first year, especially within the first 3 months (and most commonly the first month). Usually when it happens, the new stem cells attack one of these organs: the liver, the gut, or the skin. If caught fast enough, it's possible to treat GVHD with steroids. But my doctor explained there are cases where patients don't always respond to the steroids, and in those cases, GVHD is often fatal. Acute GVHD is one point where I am at high risk, because of the A-marker mismatch.
Graft Failure (when the stem cells all die and the transplant is a failure) is another possibility, but IIRC, not as big an issue as the extremely common GVHD.
Relapse is still an issue. Just because you get a transplant doesn't mean your cancer is cured. It HOPEFULLY is, but it doesn't guarantee you a free pass.
Secondary cancer (a new, different type of cancer!) is still another possibility.
So these are some of the complications of bone marrow transplants. The big one, though, is GVHD as it's so common anyway, and I'm at high risk for the "dangerous version". That being said, it's good to have *some* GVHD, as strange as that may sound, because having *no* GVHD at all could mean that your new stem cells are weak, and would not be able to handle a relapse if one were to occur. So my doctor explained that they try to aim for a little bit of GVHD with immunosuppresants; they want there to be some, but not so much that it kills you. It sounds weird, but it made sense the way he explained it to me. He's way better at explaining things than I am, for a large number of reasons, needless to say. ;)
There's also the chronic GVHD, but I'm going to talk about that one another time because this entry is already getting really long, and the chronic version tends to pop up later in life and not be as life-threatening. I'll write about it for sure, just at another time.
I hope I explained this stuff well! I might have made some mistakes, so sorry for that. I'm bad at explaining stuff in general; add in the fact that it's well past 2:30 in the morning and I've already taking my sleeping pills PLUS I've been forgetting things like crazy lately (yay chemo brain!), who knows how correct I've gotten the info here...hahha. But I try!
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