AML: The Match Game...

Since we achieved remission with more chemo, and the tests were coming back with the results we want, the next biggest concern is finding a matching bone marrow donor.

For those just joining us, I don't have a related donor.  So I had to go to the national donor registry to get a match.  I must say I was a little overwhelmed at how many people asked to join the registery on my behalf.  Even the school nurse at my kids school, sent out a flier and info for a local bone marrow drive.  (join at www.marrow.org)

The good news is that there were 4 preliminary matches found in the national registry.  After further testing I know I have a 10/10 match, a 9/10 match and one more that is still pending. 

I have been asked about how a bone marrow match is determined.  Here is my short hand version.  

First, a bone marrow transplant is really a stem cell transplant. Stem cells are essentially these blank cells can the become more specialized cells, in my case bone marrow.  Bone marrow, along with creating the various elements of the blood is where much of your immune system comes from.  Essentially I need to get these stem cells from a donor to create a new immune system in my body.  When that happens, the new immune system will see my leukemia cells as foreign and will attack them.  The trick is we don't my new immune system to take out anything important along the way. 

Second, it has nothing to do with blood type.  What we are woking with is something called HLA typing.  (Human leukocyte antigen for those taking notes).  In simple form: HLAs are proteins.  This particular proteins are in pretty much every cell we have and tell the body which cells belong in our bodies and which do not.  So the goal is to get donor stems cells that have an HLA type as close to mine as possible. 

And here is why this is uber important.  We are attempting to prevent something called Graft-vs-host disease.  Since the donor cells are creating a new immune system, the danger is not that my body will reject the new cells, it's that this new immune system in my body will reject the rest me.  At this point you should begin to see all the nasty things that could happen should my new immune system decide my liver needs to go.  (yes I know I have been at odds with my liver over the years, but we've grown close recently)

By finding a donor that has an HLA type close to mine, the hope is that we'll be able to convince this new immune system that the rest of me is not so bad and that we can all get along.  So they look at these various HLA markers in a donor, compare to mine and a 10/10 match is good.  For every step down (ex: 9/10) you decrease the chance of success 10%.  in most cases they will not do a transplant below 8/10. 

Now,  In my case I have a 10/10 match.  Sweet right?  Come to find out, that this match is a female.  The preference is that the donor be of the same gender.  As a result, they are testing one more person. So I am waiting.. 

As I understand it, in roughly 6-8 weeks we'll be able to do this transplant.  Recovery... will take up to a year or more.  Honestly, I have not even been looking that far ahead.  My advice to my chemosabes, do what you need to plan, but don't get ahead of yourself.  It just creates that much more to worry about.  Focus on the next step... the rest has pretty much fallen in line.

On a very happy note Andy and I were so happy to be part of the baptism for little cousin Isabella and niece Ava these last few weeks. 

Well friends, that catches us up to where we are today.    Lots more to come...