Tuesday, 19 January 2010

A balance of risks

I couldn’t sleep before our trip to the Marsden. At last something is happening. It was foggy once more in the night and I could hear the different notes of the fog horns but somehow they didn’t sound so malignant or mournful. In the morning as we drove along the M27 the sun was already shining. By the time we were driving along the A3 it clouded over again and we could see a few mounds of greying snow still left over.

It was a good meeting at the Marsden. Of course I’d read the book provided about transplants and seen the hospital DVD and I do know they must tell you the worst so I was prepared. The statistics are a little frightening. At my age the mortality rate from the transplant is 1 in 3 and if you survive there is a 50% chance of a cure. That sounds pretty terrible but the other statistic is much worse; with mantle cell lymphoma and having undergone 3 courses of chemotherapy, I have one to one and a half years left. No contest: a risk, yes, but so much of life is a risk and the alternative is just sitting around passively waiting for death. No, if I am going I shall go out having fought for survival.

On the plus side, I am a non-smoker and apparently my biological age is younger than my chronological age which reduces the risk slightly. On the plus side, this is the best hospital for cancer and related diseases in the UK. On the plus side, the place is bustling and the team are friendly, switched-on and efficient.

I learned a little about my donor. There is a 9 out of 10 antigen match which is good but there will inevitably be some graft versus host disease. The US are far ahead of us with cord blood transplants, the use of which largely eliminates the rejection by the host body of the transplant but in the UK we must rely on donor bone marrow transplants at the moment. My donor is a 39 year old female from Germany. To that wonderful, generous woman, my gratitude knows no bounds. There was another donor from Germany and one from Holland but they were not so good a match, 8 out of 10 antigens which is much riskier.

As I don’t have a choice of donors lined up, the hospital wants to go ahead with the transplant as soon as possible. Obviously I shall have to have time to recover from my ENT surgery but they are looking to do the appropriate tests on heart, lung, kidney function and liver, the insertion of a Hickman line and a PET scan to determine the effectiveness of the radiotherapy in mid February. The Hickman line means that blood tests and drugs can be administered through that instead of through my poor arm where, after months of chemotherapy, the veins have collapsed. All being well, this means I should go into hospital at the end of February for the high dose chemotherapy and be ready for the transplanted cells in early March. At last a tentative, but possible time-table is emerging.

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