BMT Clinic at Moffitt Cancer Center.
Today was Dad’s first day of five pre-transplant testing days. The day started in the BMT (bone marrow transplant) clinic with a visit with Theresa, the social worker who was filling in for Penny, who is out of the office this week. Penny is the social worker assigned to Dad. The social worker is a member of the transplant team responsible for providing assistance with resources such as local housing and for providing family or individual support and counseling. Theresa asked Dad a number of questions to obtain a view of his physical and mental history. Mom and I responded to caregiver questions since we are serving as the primary and secondary caregivers, respectively.
Moffitt Cancer Center Allogeneic Transplantation Patient and Caregiver Guide.
A main topic of discussion and of high importance to Mom and Dad was nearby lodging required for the first 75 days after being discharged from Moffit post-transplant. The rule of thumb is that the Dad would need to be within 30 minutes of Moffitt. Dr. Ayala, Dad’s transplant doctor, and Denise, the transplant coordinator, made it clear during our initial BMT visit this summer that Dad would have to reside closer to Moffitt than their condo in South Tampa. On a good day without traffic, the drive to Moffitt from South Tampa would take no more than 20 minutes. Unfortunately, traffic and South Tampa flooding are unpredictable. Anyone living in South Tampa this summer experienced heavy flooding multiples times, which resulted in many impassable roads. Mom was disappointed to hear that the Hope Lodge is closed for renovations and is scheduled to reopen in April. The Hope Lodge is conveniently located across the street from Moffitt. Our lodging options are now Marriott’s TownePlace Suites, Marriott’s Residence Inn, and the Lodges at Lake Crest. All are located approximately ten minutes from Moffitt. Both Marriott hotels provide shuttle service to and from Moffitt. Mom stressed the need for excellent cleaning services. We learned that Moffitt procures its own cleaning services for the Moffitt rooms at the hotels since the transplant patients are at high risk of infection.
This afternoon, Denise, the transplant coordinator, provided the results of Dad’s bone marrow biopsy and skin biopsy. The bone marrow biopsy showed some chromosomes that may be an early indicator of Myelodysplastic syndrome (MDS). The good news is that Dad’s bone marrow seems to be ever-so-slowly recovering from the pancytopenia caused by his Campath treatments. This morning Dad had a blood draw to check his counts and to determine if he needed a blood transfusion today. Dad’s platelets are up to 32 (32,000) from 19 (19,000) a couple weeks ago. (A normal platelet count ranges from 150,000 to 450,000 platelets per microliter of blood.) His hemoglobin was 7.7. (For men, a normal hemoglobin level ranges from 13.5 to 17.5 grams per deciliter). Dad did not need a blood transfusion since his hemoglobin was >7.0.
The skin biopsy indicated the presence of CD30. This is actually good news in that Dr. Sokol, malignant hematology, may be able to treat Dad systemically with brentuximab vedotin, which is an anti-CD30 monoclonal antibody and is less toxic than chemotherapy. Dad’s bone marrow, immune system and blood are unable to withstand any chemotherapy treatments at this time. Our hope is that a systemic treatment will address Dad’s internal tumors.
Dr. Ayala, transplant doctor, wants to execute the transplant as soon as Dad completes his radiation treatment. Thus, we are assuming an early February transplant. Since both of Dad’s siblings passed earlier in life, Dad had to find a match through the donor database. Dad is blessed in that he has two matches. Both donors are located outside of the United States. Truly amazing.
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