Day -7 of Stem Cell Transplant #1

On Wednesday, Theofanis began next phase of his treatment: Stem Cell Transplant #1

An autologous stem cell transplant for the treatment of high risk Neuroblastoma involves high dose chemotherapy and re-infusion of the patient's own stem cells which were harvested after Chemo cycle #2.

Some things to know about Theofanis' autologous stem cell transplant:

• Theofanis stem cells have been frozen and have been stored at the the U of C Medical Center.
• There is no surgery involved. His stem cells will be hung on his IV pole and re-infused through his central line, similar to a blood transfusion.
• Theofanis will be given high doses of chemotherapy drugs for a period of 5 days.
• These drugs will kill and suppress all new cell growth to the level that they cannot recover on their own.
• Theofanis will "rest" for two days during which he will not receive any additional chemotherapy.
• The stem cell transplant is really a "stem cell rescue." His own stem cells will rescue the killed marrrow that cannot recover on its own.
• Some people call it a "rebirth."
• Until he recovers, Theofanis will have zero immunity, and that is why he is in isolation and has extreme dietary restrictions to prevent any type of bacterial, fungal or viral infections.

There is a daily count-down and a count-up during the duration of the stem cell transplant:

• The first day of chemo is called Day -7
• The second day of chemo is called Day -6
• The third day of chemo is called Day -5
• The fourth day of chemo is called Day -4
• Fifth day of chemo is called Day -3
• The next day is a day of rest and has no chemo and is called Day -2
• And the day following also is a day of rest with no chemo and is called Day -1
• The day Theo gets re-infused with his own stem cells or "Super Cells" as he knows them to be is called Day Zero.
• Then, his 100+ days of recovery begins and the count-up begins: Day 1, Day 2, Day 3, etc.

Kosta and Eleni aren't quite certain of the day count now that Theofanis is following a tandem transplant protocol. They are calculating that the entire process including isolation will be approximately 144 days. But what they are certain of is that Day Zero falls on October 26th, the Feast Day of Saint Demetrios, the patron saint of their beloved church and their first-born daughter. This most holy day will mark the rebirth of their son's cells and prayerfully and hopefully, the end of every unwanted cancer cell in his body.
 
On Day -7, Theo received a drug called Theiotepa over a 2 hour infusion period.

Theo also received a red blood cell transfusion because his hemoglobin was a low 7.7 upon admission.

As profilactic measures against side effects, Theo was given anti-nausea medicines, three different oral rinses (4x/day each), a stomache soother, and was required to shower every six hours to get rid of skin secretion from this particular chemo.

By the way, Eleni and Kosta are calling the drugs he is getting during this phase of treatment, "medicine for the stem cell transplant." Psychologically, Theofanis has had enough of "chemo". The challenge now is to make sure the staff remembers to not call it chemo in front of him. There have already been slips, but Eleni explained to him that the staff takes as much care with these drugs as they do with chemo, so that's why they call it that sometimes.

Aside from the strict regimented schedule, Theofanis had a rather good day. He was feeling good, as he usually does on the first day of therapy. He did some homework, he ate well, he started his 1400 piece Star Wars legos set, he played Wii, and he played football on his iPad and made enough touch downs where his score ended up being 100 to 0. Bears vs. Lions. (Remember, I said it was a game, not reality.) His doctors visited him, and he was taken care of by one of his favorite nurses, Abby. He chatted with his sisters on Facetime, too. Eleni spent the day and night with him, and Kosta visited for a little bit. And finally, every doctor, nurse, child life specialist, and staff member who came into his room commented on his decorations and all the get-well cards and "You Will Win" posers taped to every wall of his room. "You have a lot of people who love you a whole lot," they told him. And yes, that is so very, very true!

Day -7 is done!

ps. Please be sure to read the previous blog post which captures all the events leading up to his first day of his first stem cell transplant.