A stem cell named Wanda

Hello, I am a stem cell from batch 21KN03164 from the St. Louis blood bank. I am currently floating around in Drew Llewellyn’s blood stream.

Where did I come from? A couple in St. Louis had a baby a few years ago, and they donated the blood from the umbilical cord of their little girl after a healthy, normal birth. I was a stem cell in the blood. I and my friends stayed in a little bag in the freezer until last month, when I was sent to Duke to be thawed and tested and put in red Koolaid (well, probably something similar) in a bag with Drew’s name on it.

Don’t worry, I am not controversial. There are many types of stem cells. I am actually classified as an adult stem cell, meaning I am able to produce only a special set of cells. While embryonic cells can produce brain cells, heart cells, and all the other 200-plus types, adult stem cells are specialized. I can produce only blood stuff: red blood cells for carrying oxygen, white blood cells to fight diseases (like cancer), platelets which clot the blood, and cells which build connective tissues and cartilage and such. I can’t produce cloned sheep or three-eyed people or new heart valves, so no Republicans want me flushed down the toilet.

Yesterday, I was in the second bag that Drew received (boys always get to go first). I will be with Drew forever, assuming I win the fight. While blood cells die every few months and have to be renewed, I stay around in the body. I mostly sit in the bone marrow, the stuff inside the big bones. I can keep producing blood cells for his whole life. The cells I produce can fight diseases like lymphoma, too.

Drew now has three types of stem cells in his blood – we St. Louis ones, a North Carolinia boy’s cells, and his own. However, since he has had radiation and chemo in the past month, his own stem cells are not working now (as planned). He has almost no white blood cells left, and his platelets are so low he is getting transfusions. His stem cells, even the ones hiding in his bones, are mostly gone as well.

The new ones, including me, are quite strong, however. Being very young, we are also very adaptable and easily influenced. We will look for homes in his bones and tissues and take up residence. We will produce lots of new cells soon, and his blood tests should pick up new, improved numbers.

Life, however, is not simple here in Drew’s bloodstream. Like three-year olds fighting for a single toy, we are creating a cat fight in the coming weeks.

First, we three stem cell types will fight each other. One will win. The others will disappear over time. Since it should be one of us new guys (since the radiation zapped his old stem cells before we arrived), it is just a matter of time before one group of us takes over and become the dominant stem cells. While we fight, though, Drew will need some transfusions to keep up his blood supply.

Second, we will cause Drew some problems getting moved in. Since one of the cell types we will produce, the white cells, attack foreign junk that gets into the body, they will start looking for things to attack. Being new to Drew, the new white cells may attack Drew’s good cells and make him sick. Remember, we are young and easily misled.

Drew’s medical team will watch this sticking, fighting, and feuding with interest. They have started drugs to make us grow faster and stick better. They have started drugs that will make us less likely to attack Drew. And they will continue to give Drew drugs to fix the problems caused by the chemo and radiation which won’t harm us but should help his mouth, intestines, skin, and full-global baldness (looks cute, though). And in the coming weeks, the doctors will start to test to see who’s winning, and how well we are growing, sticking, and creating new blood cells. They will declare success at some point, which averages about 21 days and may be 15 to 40 days.

Success won’t mean done. Stem cells still take loving care. We won’t give Drew a full immune system for months, so he will be outpatient and have a restricted life for two months after he is released, at least. He will take some drugs for six months and have lots of doctor check-ups. And that is if everything goes according to plan. We hope it does.

So it is great to be part of TeamLlewellyn. And if I win, I promise not to make Drew want to play with dolls. Or make him smarter or better looking. Those are his jobs.

(PS: Drew had a sleepy day - everything working and hurting on schedule. If you want a more normal story on the stem cell transplant process, click on http://www.mayoclinic.com/health/stem-cell-transplant/CA00067)