Tuesday, April 15, 2008

Bone marrow transplants bring new birthdays

Today is my half birthday. I am six months old.

Most people know it as tax day, and for me it’s that too. But it is also a kind of marker on my leukemia journey. Six months ago, I got my second bone marrow transplant. It was Oct. 15, 2007 – my new birthday. Actually, it was my second new birthday, making a total of three birthdays in all.

Aug. 24, 1954 was my real birthday.
My first transplant, on Sept. 18, 2003, marked my “new” birthday.
I had hoped it would be the end of leukemia for me. I got what is known as an autologous transplant, using cells collected from my own bloodstream after I went into remission. I received these cells back intravenously to repopulate my bone marrow after my third, and most intense, round of chemotherapy depleted it.

I took a long time to recover, including a year at home while my weakened immune system grew stronger. I was always afraid of recurrence, but as time went on I became more confident. When I passed the two-year mark, I felt especially good. That is the point at which the disease is extremely unlikely to return.

But as I discovered in August, 2007, unlikely does not mean impossible. I felt great and was back to my usual self – working full-time, doing yoga, lifting weights, and running, biking and playing tennis. I was nearly four years “out.”

My doctor saw the signs of trouble in a routine blood test, and then he performed a bone marrow biopsy that showed the leukemia had returned.

I found it nearly impossible to comprehend, and immediately began to wonder if I had done something to bring this on, or if, conversely, there was something I had not done but should have. My doctor said it was nothing I did, or didn’t do. It just happened.

An article that I recently wrote for the Dana-Farber Cancer Institute's website, headlined "Baby Steps and Beyond," tells the story. Short version: I had to go through chemotherapy and transplant again. This time I had an allogenic transplant, using marrow from a donor. The idea is that donor marrow is insurance against the leukemia coming back; the new cells recognize invading cells as foreigners and attack them in a way that my own cells were unable to.

Recurrence, of course, is a whole new ball game.
Physically, it was probably easier the second time around. Mentally and emotionally, the story is more complicated. You feel more fragile, more vulnerable, yet you have the benefit of already having learned coping skills from the first time around.

You have to take time to give thanks for the progress made by medicine and for the progress you have made. I am not yet allowed to know my donor's identity, but we have exchanged anonymous cards. He is 53, a father, and lives somewhere in the United States. That's all I know about him, except that he is extremely generous, and that he gave me a second chance.

So on my six-month birthday, I send him thanks, wherever he is.

No comments: