I am now neutropenic. This means that there has been a significant drop in the number of neutrophils in my blood stream. Neutrophils are a particular type of white blood cell which are used as part of the bodies immune system. The neutrophils contain sacks of enzymes which digest microorganisms.
The effect of the Melphalan has been to destroy the Myeloma cancer cells along with the ‘good’ cells of my body. In a process over the last week my stem cells were killed off, so that when the healthy cells died (as they do naturally all the time) they were not replaced. This has been noticeable in my mouth, throat and gut where the loss of cells has resulted in a sore mouth and tongue, and some gastrointestinal issues.
The reintroduction of my stem cells via transplant has proved a new source of neutrophils, but there will be a delay. The cells have to migrate to my bones and take time to develop into the neutrophils, platelets and red blood cells needed. I am currently having GCSF injections to stimulate this process.
It will be a few more days before my neutrophils will begin to rise again. In that time the biggest risk is infection from those bacteria which live on my skin. Precautions include the use of mouth washes, regular hand washing, my presence in a private room. Nurses who treat me must wear disposable gloves and may need face masks if they have signs of a cold.
For now I remain reasonably fine, though increasingly tired.