Friday, March 5, 2010

Snow Globes and Accountants

Well, I didn't translate the data correctly and so my math was wrong. Turns out the day #1 harvest (Thursday) only yielded about a third of what was needed (not the 70% I reported).

Many have heard me explain that I became an Accountant/CPA for one reason and one reason only--my dad. My dad has always been my hero and since he was a CPA, that's what I always wanted to be.

I like to tell people: "There's 3 kinds of accountants; those that can count and those that can't."

So, let me start by correcting the report:

Day #1 (yesterday): 5.5 million stem cells harvested (per kilo) = 60.5 million total
Day #2 (today): 2.8 million stem cells harvested (per kilo) = 30.8 million total

We've got to get to 165 million total and we're only at 91.3 million after two days. (Correct percentage complete so far = 55%)

Another clarification: we want the CD34 stem cell markers to be as high as possible during harvesting. They jumped from 9.9 on Wednesday to over 32 yesterday (the peak); they were down to about 18 this morning. So, they did time the peak perfectly. They just didn't get the yield they expected.

It's beginning to look like we may have to harvest again after induction cycle #3. They are attempting to bolster the CD34 marker cells by starting what's called the "hard to mobilize regiment". This involves hitting Talitha really hard with large quantities of growth factors including additional doses of the neupogen she's used to and now an additional one that's called GMCSF. They are trying to "shake up" her bone marrow to overproduce and spill out the CD34 markers into the blood stream for easier collection. (In the '80's, they used to surgically open up bones and harvest right from the actual bone marrow itself. Thankfully, they have found a far less invasive answer that filters blood instead of poking around in bones.)

Think of a snow globe. All the little white glitter rests at the bottom till you turn it upside down and shake, shake, shake. Then for a few moments, you see the water filled with so many specks it looks like it's snowing.

That's kind of what's happening in Talitha's body. Stem cells (CD34 markers) reside within the bone marrow like glitter resting on the bottom of a snow globe. Chemotherapy comes along and shocks Tali's system (turns her upside down). Then neupogen overstimulates the bone marrow (shakes her like crazy). This makes the CD34 markers empty into the blood and for a "few moments" stem cells are "snowing".

The harvest trick is to catch as many of those stem cells as possible before they settle back into the bone marrow. In Tali's case, they didn't catch enough the first time so they're trying to shake, shake, shake some more.

One tiny, eensy weensy problem with all this. Talitha's not a snow globe.

All that shaking is hard on her little body. And it hurts. Bad.

So I look through the tears for my blue wristband and I "Pray for Talitha".

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