The Days After...

Wednesday and Thursday - - > Plasma Pheresis or Plasma Exchange

Ganito kasi ang scenario – sabi ng doctor ko, MY CASE, was ONE FOR THE BOOKS…lahat na daw ng hinde usually nila pinoproblema naibigay ko sa kanila…yup…I gave them sleepless nights…hehehe

Simula nung na-diagnose ako May last year, I’ve had 3 chemotherapy cycles na…the first one (June), not in remission (Remission means, no more leukemia cells sa bone marrow, plus blood counts recovering at the expected time) so ako nga hinde…the second one (July) semi-remission lang plus hinde nagre-recover counts ko…Usually after chemo, yung counts bumabagsak at the 14th day, yun yung expected lowest day…then by the 28th day naka-recover na…ako nung 2nd, we had to wait 40+ days…nag-decide na lang na mag-chemo na uli before it’s too late kahit wala pa rin talagang dugong tatamaan yung chemo drugs…

My 3rd chemo nung September, parang preparatory na dapat sa transplant…parang “salvage” scenario na kami kasi alanganing remission tas hinde pa nag-recover yung counts…transplant nga pero hinde yung usual expected results compared sa “in remission” patients….So dapat October…pero dahil sa baba ng counts ko tinamaan na ako ng infection…na-move…November…tas December…tapos Feb tapos sa wakas eto na…

Sa huling bone marrow aspiration ko, remission daw yung marrow, that was December last year…so parang ang pinaka-problema na lang was kung bakit hindi bumabalik sa normal yung counts ko as if huminto na/super super bagal na yung marrow ko magproduce ng bagong cells…The doctors had to rule out another blood disease called Aplastic Anemia (almost similar sa symptoms ko)…

So ayun, Transplant Time na nga talaga…swerte kasi may donor ako…si kuya Fidel (hay naku kung wala pa, baka nag-give up na yung doctor ko) pero may bago na naming problema, hinde kami magka-blood type, type O+ ako siya B…so incompatible, kung hinde gagawan ng paraan masama…

So ayun, dumating na ako sa part nung ikukwento ko for Wednesday and Thursday…
So dahil dun sa blood type incompatibility kailangan nila bawasan yung Anti B ko sa dugo…ganito kasi yan:
Sa mga Type A – may anti-B
Type B – may anti-A
Type AB – wala both
Type O – may anti A & B
Tama ba? I guess…so since ang donor is B, they would have to take off the B antibody in my blood…well actually depende pa rin kung mataas yung antiB titer sa dugo…and sa case ko pa rin, mataas nga, so mataas ang risk na I-reject ko yung Ita-transplant na typeB blood so dun pumapasok yung Plasma Pheresis…nasa plasma part daw kasi ng blood yun…

Eto ang clip ko:
The terms therapeutic apheresis, plasmapheresis, and plasma exchange are often used interchangeably, but when properly used denote different procedures. Apheresis is a general term describing removal of blood from a subject; a portion of the blood is separated and retained while the rest is returned to the donor. Plasmapheresis, in which plasma is separated and manipulated in a variety of ways, is probably the most common type of apheresis procedure.

Plasma exchange (PE), in which the plasma is isolated, then discarded and replaced with a substitution fluid such as albumin, is frequently done in conjunction with plasmapheresis. Plasma exchange is a nonspecific therapy, since the entire plasma is discarded.
The rationale for PE is based on the fact that circulating substances, such as toxins or autoantibodies, can accumulate in the plasma. Also, it is hypothesized that removal of these factors can be therapeutic in certain situations. Plasma exchange is essentially a symptomatic therapy, since it does not remove the source of the pathogenic factors. Therefore the success of PE will depend on whether the pathogenic substances are accessible through the circulation, and whether their rate of production and transfer to the plasma component can be adequately addressed by PE. For example, PE can rapidly reduce levels of serum autoantibodies; however, through a feedback mechanism this rapid reduction may lead to a rebound overproduction of the same antibodies. This rebound production of antibodies is thought to render the replicating pathogenic clone of lymphocytes more vulnerable to cytotoxic drugs; therefore, PE is sometimes used in conjunction with cyclophosphamide.

So ganun ang essence niya…they had to collect 2 liters of plasma last Wednesday…tapos another 2L kahapon…I’ll have a CBC and blood works tomorrow…I might need a platelet transfusion…so I’ll have type B platelets (and plasma if ever) na infused to me…tapos RBC donations will remain type O…

Astig kasi during transplant lang pwede magpalit ng blood type ang tao…(during birth nasa genes na yun…)so after the engraftment period ng transplant, magiging Type B na ako…full-pledged…hehehe

So ayun, sa mga may mabubuting loob donate naman kayo ng dugo…
The doctors prefer Platelet Pheresis (same concept sa Plasma pheresis) para yung ita-transfuse na dugo sa akin would come from one donor na lang unlike before…that means less transfusion reactions din…the pheresis would take around 4 hours (bawal tumayo para umihi) so extra effort sa aking dear donors…

For other donors who don’t have plenty of time, pwede pa rin naman yung usual blood donation time pero you’ll be giving me blood I can use during packed RBC transfusion sessions…
So ayun po….Type B – Platelet Pheresis
Type O – usual blood donation
Sa St. Luke’s, you’ll have to have the usual screening pero mejo matagal ang waiting time lalo na sa pheresis donors kaya give enough time na rin…basta please contact me (and my family and mike) if you’re interested in giving me blood and saving a life….

Drama…pero you’re giving me your blood or at least may effort pero hinde talaga pwede, thank you…