Adventures with Phred: Stem cell transplant resets body’s immune system
Doug Reicher, 65, was diagnosed with acute myeloid leukemia last summer. His treatment at Upstate University Hospital began with intravenous chemotherapy, which meant he would need to be connected to a device on an IV pole that would keep the medications flowing.
The couple shared an upbeat chronology of Reicher‘s adventure, which has taken place over several weeks in the hospital and included not just chemotherapy but a stem cell transplant using cells donated by one of Reicher‘s nieces. Today he‘s recovering at home.
Stem cell treatment
Doctors and nurses at Upstate have long offered autologous stem cell transplants, where a patient‘s stem cells are extracted from his or her body before chemotherapy and then returned. In 2018, they began offering allogeneic stem cell transplants under the direction of Jeffrey Pu, MD, PhD, director of the hematologic malignancies program and the stem cell transplantation therapy program.
Pu explains that “you can engage immune reactions” by using stem cells from a healthy donor who has been matched with the patient. “Those immune reactions can further kill residue or circulating leukemia cells or lymphoma cells.”
For patients undergoing stem cell transplants, “Their white blood cell count goes to basically zero, so they are at high risk for infection,” explains nurse Meghan Lewis. The day they receive the transplant becomes Day Zero, and patients typically remain hospitalized for two or three weeks afterward.
Reicher wrote on CaringBridge when he was allowed to go home that “my cell and immune system will be that of an infant. I have to grow a new system and will have a functioning but immature system, just like a baby.
“Infection is the greatest risk, so I will have to be very careful at home with food, the house and visitors.” Eventually Reicher will receive a new series of immunizations against childhood diseases such as polio, measles and whooping cough.
2 types of stem cell transplant
Autologous stem cell transplant — a patient receives his or her own stem cells, which are removed from the patient‘s body and frozen for safekeeping while he or she undergoes chemotherapy. Afterward, the stem cells are returned to the patient‘s body. This is a treatment option for patients with multiple myeloma or lymphoma.
Allogeneic stem cell transplant — patients receive stem cells from a healthy matched donor. This is a treatment option for patients with leukemia or lymphoma that has relapsed.
This article appears in the winter 2019 issue of Upstate Health magazine.