Chemo chemo chemo chemo chemo chameleon

There is much to be discussed.

I am getting that stem cell transplant, after all. I don't know who my donor is like to be, hopefully one of my two stupendous siblings; a complete HLA match would be delightful, and would cut down significantly on the number of pills in the daily handful I'll be taking for a while. Did you know that after an allogeneic, or donor,  hematopoietic stem cell transplant (stem cells obtained from bone marrow, obtained through dialysis; I'll get to the technical terms in a bit) you have to get jabbed again for most, if not all, of your immunizations? I did not, but have learned this through a combination of wikipedia and assorted journal articles. I've been doing some light reading. 

They're going to be all, "TETANUS, SON! WHAT!" 

And I'll be all, "But you're white and went to an Ivy League school! This characterization doesn't even make sense."*

"Docta's can be gangsta! Lookit Doc Dre, bee-yotch." The doctor might reply, nonchalantly.

*Yes, the doctor could, and in fact is more likely to be black (or brown, I ain't leaving out my caramel peeps) given that I do live in Saskatchewan and we import most of our doctors from places with far more human history than we can boast; in which case my comment would have gone something more like, "But you grew up in X_nation, you didn't grow up in a culture that prides itself on keeping it real!" 

The HLA, or Human Leukocyte Antigen, is the specifc name for the MHC, or Major Histocompatibility Complex, in humans. It is the chunk of your DNA that tells the cell what funny hats to wear so that all the other cells know that that cell is part of your body, and tells your immune system not to attack it as something foreign. You can also think of the HLA as a uniform, if that makes more sense. "I work here, too! I'm the same as all of you!" In this sense, conformity is good. It's a lot more complicated than that, but for the purposes of our discussion, that'll do just fine. 

For a successful stem cell transplant, with no complications, your best bet is a complete and total HLA match. For that reason, autologous stem cell transplants, using a person's own stem cells (I know that seems counter-intuitive, but if there's no cancer in the bone marrow, then you can do it) are preferred. The closer a match you are, the less chance there is of developing Graft-Vs-Host-Disease, or GVHD. It's in high def. GVHD is usually very manageable, but it's not a good time. The ideal situation is having an identical twin without cancer, guaranteeing a perfect match: wonder-twin powers, activate. The next best bet is those siblings you've been bugging so maliciously over the years, at a whopping 25% chance each of being a perfect match. After that the odds drop precipitously, but non-related matches do occur, and they're why there is a donor list in the first place, that's what it's for. If there are no perfect matches, a doctor may elect to choose an imperfect-but-close match, and the risk goes up as the quality goes down; or, depending on what sort of ailment you are encumbered with, that doctor may elect to wait for one, which has the downside of a potential relapse on the part of the patient.

The donor is given a Granulocyte-Colony Stimulating Factor, or G-CSF, such as filgrastim. The meds are injected over the course of four or five days, and they cause your bone marrow to hyper-express the stem cells that would become red and white blood cells. Point of interest: your body makes stem cells all the time; one doesn't need to harvest foetal leavings from abortions for this sort of thing. There is no baby involved (unless you're doing an umbilical cord blood transplant, but that's a whole other thing), so put your protest signs back where they belong: on a bonfire**. The donor is then hooked up to a dialysis machine that filters off the cells of interest and gives the donor back their red blood cells. Those collected cells are stored until needed.

**Side note: Pro-lifers really frustrate me, because if they really cared about the lives of those infants, they would encourage and fund the SHIT out of proper sex-ed and widely available birth control, not to mention social welfare programs to help those people out once they're born. But no, it's always tax cut this, slash social programs that, oh, you're out of the womb? Good luck chucklehead. Hypocrites. 

Also: pro-life is a false stance. No one is pro-death. 

I, as the patient, the donee, if you will, get two rounds of heavy-duty chemo to wipe out my immune cells, and then I get a bowl of pills at my bedside, which I will eat like peanut m&m's (not to mention the stuff they're going to hook straight to my veins). Once that's all taken care of, I will be dosed with the donor stem cells, which will take root in my bone marrow and begin to express themselves in my body. This is where that HLA and GVHD stuff comes into play: if the donor stem cells do not recognize my body as their own, they can attack it.

And, of course, I'll be taking antibiotics and steroids and antifungals and antivirals to keep me from getting sick from basic existence.  I'll be immunocompromised for some time. There will be three-to-four weeks of Bubble Boy time, at RUH, followed by up to two years of reduced immune capacity, and plenty of doctor's visits.

Addendum: just post time of writing, I got a text from my brother telling me he is not a match. Bummer.