Treatment

After several weeks of waiting for test results to come back, everything is finally in and a treatment date has been set. The treatment is called High Dosage Cytoxan (Cyclophophamide).  As I mentioned before, Aplastic Anemia is often found to be an auto-immune disease.  In auto-immune diseases the body attacks itself.  In my particular case, it's believed that a certain type of white blood cell, lymphocytes, are attacking my bone marrow cells (stem cells) and inhibiting these cells from producing enough blood to sustain myself.  Bone marrow cells  possess a particular amino acid, which make them resistant to Cytoxan.  Lymphocytes, neutrophils, and other cells that comprise the immune system do not possess this amino acid.  The idea behind this treatment is kill off all the immune system cells that could possibly attack my bone marrow cells (bringing my immune system to zero).  Once that's complete, I'll be injected with GCSF which stimulates the production of bone marrow cells.  The goal is to have my bone marrow cells regenerate an immune system, from nothing, like that of a new born baby, that does not attack itself.   For informational purposes, I'm going to lay out what I'll be going through.

Cytoxan (Cyclophosphamide) is a chemotherapy drug that's been used on cancer patients for many years.  It's a highly immuno-suppressive drug, that I'll be given intravenously, for 4 straight days.   During this time, I'll be admitted to Johns Hopkins, monitored closely, and given a number of prophylactics (anti-fungal medications, anti-biotics, anti-virals) in preparation for my hospital discharge.  I'll be discharged from the hospital on the 5th day in order to continue treatment as an outpatient.   It sounds a bit counter-intuitive to be released from the hospital with no immune system, but statistics show that a person is much more likely to catch an anti-bacterial resistant strain of infection, at a hospital, than anywhere else.

I'll then be seen at IPOP, a special area of Johns Hopkins set up to deal with immuno-suppressed patients, everyday for 60-90 days.  The name of my game will be to avoid germs, infected people, and little kids at all costs. I'm completely stocked with respirator masks as well.  The danger with any immuno-suppresive form of chemotherapy is infection during the time of immuno-suppression.  Fevers are a very serious matter and I'll need to monitor my temperature constantly.  At the first sign of  infection, I'll be directly admitted to IPOP for intravenous anti-biotics/anti-fungal medication, as I won't have the defenses to fight off so much as an upper respiratory infection.  It takes about 60-90 days for the bone marrow to produce a significant amount of white blood cells to that I can fight off infection on my own.  Once those numbers rebound, I'll be able to leave Baltimore and continue supportive treatment in Dallas or Oakland.  It takes an additional 3-5 months for my other numbers to rebound to normal.  Fathers better watch their daughters on that day.