Pre-Transplant Appointment with Dr. Burt

I had my appointment with Dr. Burt today. It was the usual checkup, all of the test results have come back fine, and a chance to ask questions.

Since my evaluation in March, there haven't been any other transplants using cord blood. Of the 10 done so far on patients with various autoimmune diseases, 1 of whom had Crohn's, they are all doing very well with no major complications. There may be another Crohn's patient who will have one done soon as well, pending insurance approval.

The 2 cords Dr. Burt has picked for me are both 6/6 matches, and are my blood type, O+, as well. The infused stem cells will play a large part in the makeup of my new immune system. Since there will be 2 different sets of stem cells used, one of them will "win out" over the other and it will influence the makeup of my immune system. The less of my current immune system that comes back, the less likely it will be to relapse. I will have blood drawn pre-transplant for chimerism analysis, to establish a baseline, and again at 6 months post-transplant to measure engraftment. This will give them a percentage of how much of my new immune system is based on the stem cells or from my genetics.

Any possible allergies with the new immune system would be derived from the influence of the infused stem cells. Only the umbilical cords of healthy people (no medical history of disease) are saved. Some transplant patients reported that they no longer had more common allergies (such as hay fever).

DNA typing to check for genes associated with developing Crohn's isn't worthwhile. It is still uncertain exactly which genes are involved anyway, and most insurance companies wouldn't cover it, so it would be $5,000 out of pocket for even a basic panel. It wouldn't end up meaning much.

The chemotherapies I will be given are Cytoxin and Campath. I'll get a schedule soon of what will be done over the 8 days of chemo.

I was given a health survey and the consent form to read and sign. I have a dental appointment in the morning, which will be the 3rd to last piece of the pre-testing. If all goes well, I should be cleared for the transplant sometime next week and then the cords can be sent to the hospital.