T Minus 3 Days Til' Transplant

11/23/13 – Yesterday went great. I actually got to play my guitar, walked about 2 miles around the nurses station (22 laps makes a mile). I really haven’t had any effects from the last couple days of chemo. I had visitors of my wife, Sue and daughter, Alli. Today they will be back and also my other daughter Jill will be joining us.

The plan for the day is to get my doses of Fludarabine and Cyclophosphamide. In addition I will also get ATG. Tomorrow I will get another dose of ATG and start with Tacrolimus.

WOW these are some big words. Let me help by giving some brief descriptions.

• ATG is an infusion of horse or rabbit-derived antibodies against human T cells, which is used in the Gee I wonder prevention and treatment of acute rejection in organ transplantation and therapy of aplastic anemia. Gee, I wonder if I am going to start craving raw carrots.
• Cyclophosphamide is a drug that is used primarily for treating several types of cancer. In order to work, cyclophosphamide first is converted by the liver into two chemicals, acrolein and phosphoramide. Acrolein and phosphoramide are the active compounds, and they slow the growth of cancer cells by interfering with the actions of deoxyribonucleic acid (DNA) within the cancerous cells. In addition to slowing the growth of cancerous cells, cyclophosphamide also suppresses the immune system and is referred to as immunosuppressive.
• Fludarabine or fludarabine phosphate (Fludara) is a chemotherapy drug used in the treatment of hematological malignancies (cancers of blood cells such as leukemias and lymphomas). It is a purine analog, which interferes with DNA synthesis.
• Methotrexate, abbreviated MTX and formerly known as amethopterin, is an antimetabolite and antifolate drug. It is used in treatment of cancer, autoimmune diseases, ectopic pregnancy, and for the induction of medical abortions. It acts by inhibiting the metabolism of folic acid. I will start taking this after the transplant.
• Rituximab (trade names Rituxan and MabThera) is a chimeric monoclonal antibody against the protein CD20, which is primarily found on the surface of immune system B cells. Rituximab destroys B cells and is therefore used to treat diseases which are characterized by excessive numbers of B cells, overactive B cells, or dysfunctional B cells. This includes many lymphomas, leukemia, transplant rejection, and autoimmune disorders.
• Tacrolimus is an immunosuppressive drug that is mainly used with allogeneic transplants to reduce the activity of the patient's immune system and so lower the risk of rejection. 

 I just have to thank God every day for all the blessings in my life, my wonderful loving wife, the best daughters any one could wish for and so many great family and friends.

And I guess I need to thanks our animal friends, after all some rabbit or horse has “donated” the key components for the ATG I will get today.

And God created great whales, and every living creature that moveth, which the waters brought forth abundantly, after their kind, and every winged fowl after his kind: and God saw that [it was] good.

Genesis 1:21

More to come…

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