Plan C

The fight goes on. We now have a plan for Drew’s next battle.

The results from Duke’s Adult Bone Marrow Transplant testing came in last night. Plan A was to use one of Drew’s siblings as the donor, but luck was against us. Ben was close but not close enough for an initial transplant. Six factors are considered for a match, and he and Drew only share three. Plan B was to use a donor from the 5.5 million registered donors in the National registry. While there are a few matches in the registry, Drew’s condition will not let us wait for the retesting, preparations, and donor scheduling required to bet everything on a quick Plan B.

Plan C, the cord blood option, is therefore in effect. Drew will finish his latest chemo next week. Then for two weeks or so, he will be tested and prepared for transplant, both in Charlotte and at Duke. He will have a major blast of “total body irradiation”, which will kill his cancer and his own bone marrow. He will immediately get the stem cells from two cord donors (where blood is saved from the umbibical cord of newborns). While cord blood has been used for several years to supply stem cells that can renew the immune system, Drew’s two-donor procedure is fairly experimental, necessary because of the number of stem cells needed for a full adult. Most cord blood transplant go to kids or smaller folks than Drew, but he will need a mix of two donors to have enough. (Click Here for more information on cord blood versus bone marrow transplants) The cord blood has been donated by parents of healthy newborns to this relatively new program. It has none of the ethical issues of other stem cell research.

This plan has some excitement. The next two weeks will include tests, transfusions, and possibly some side effects of getting this round of chemo early. The dual cord blood transplant has more chance of rejection, given two new immature stem cell types in his body. Our doctor expects the Duke team to have a backup plan or two, which will include Ben as a ready donor and potentially an unrelated donor standing ready as well.

So we expect to be at Duke by the first week of May. Details will dribble out over time and, as our doctor says, will always be subject to change given the very few times this procedure has been used.

We asked if we could find this procedure in the literature. The reply was that when we successfully complete this one, we may become the literature!