Questions

[camiboxer]

I have some curosity questions that in the grand scheme of things don’t make that much difference but I would still like to know all the same. If anyone could explain any to me or point me in the right direction for answers I would really appreciate it.

When someone gets a tx of RBC does this just give the patient a “boost” of good RBC or does it help them make their own better? I guess the same question would apply to platelets as well.

When one gets a bmt, I understand that your own “bad cells” and good are killed off prior to the transplant. Do you at that time then have the donors blood type and other characteristics? Assuming that it is a success does your body then start producing the donors good cells since yours were wiped out prior to the transplant?

When the Dr. wants you to have platelets from the same donor how is this possible? However the match is found is that person then requested to supply the platelets for as long as needed and how can you ever make sure that this happens?

This is all so new to me. I have so much to learn about the disease, the treatments, meds, costs, etc….I am staring at a billion piece jugsaw puzzle and just trying to put it together as best as I can. I apologize for some many questions.
Susi

[Neil]

Hi Susi,
Packed red cell TX will not help a patient produce more red cells .They replace reds that the patient is not producing. A RBC TX can last for as long a 4 months—usually don’t.
Platelet TX last for 5-10 days depending upon the individual. The TX does not help produce more platelets. The TX provides them for those who have problems producing enough viable platelets.
BMT issues are vast and more complicated than one can put into this reply. A quick response is: a BMT involves destroying the the patients marrow and replacing it with that of a donor. This requires high doses of chemo and/or radiation. This is intended to kill off cells that may cause MDS to return after the transplant or cause rejection of the donors marrow. The body should begin to produce its own new cells in 2-4 weeks.
A stem cell transplant is probably more likely to take place considering all of the advances in SCT technology and the reduced need for as much chemo and the possible elimination of radiation in some patients.
In some unique cases it might be possible to get someone to donate platelets for a patients exclusive use. But it depends upon the number of platelet TX needed opposed to the ability of the donor to provide enough.
Are you referring to single donor platelet TX. As a rule this means if a patient requires more than a six pack of platelets the second or maybe even a 3rd bag will come from the same donor. It could be tough to have one person donate enough platelets to take care of weekly TX. A donor would have to start donating them far in advance.
Platelet TX are particularly difficult if needed over a long period of time. Single donor platelets, irradiated/filtered plts tend to extend the time a patient can go before becoming refractory. Lots of docs/clinics will insist on plt TX when a patient hits the 10,000 mark. This is regardless of the presence of symptoms. I had to cancel an appointment with a very highly regarded doc because their rules stipulated that any patient with a plt level below 20,000 had to have a plt TX before they would perform a BMB. Since I do not display symptoms and never had bleeding issues when getting a BMB I elected to cancel the appointment. That was 5 years ago. Had one TX to support my plts when some minor surgery was necessary. I don’t want to waste perfectly good plts and possibly shorten the time I would be able to get them if and when necessary.
Keep up the questions. This is the best way to learn and keep up with all of the variations posed by MDS. The more questions you ask the more you will learn and develop your understanding.
It is always a good idea to go to the home page of this site and review all of the educational materials. There is a lot of it and it is updated frequently.
Keep in mind that MDS technology is changing quite rapidly. Much of what I learned 8-9 years ago is pretty well obsolete today

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