Day Plus 1-The Start of the Grafting Process

Not too much happening on the day after transplant. I did receive my first treatment of Methotrexate (MTX), which is a chemotherapy agent and immune system suppressant, given on Days 1,3,6,11 to suspend T-cell growth. I also received a continued small dose of Tacrolimus (which started the day before transplant),  an immunosuppressive drug used mainly after allogeneic organ transplant to lower the risk of organ rejection. It achieves this by inhibiting the production of interleukin-2, a molecule that promotes the development and proliferation of T cells, which are vital to the body's learned (or adaptive) immune response. It basically suppresses the immune system from growing too fast. Otherwise, my day was filled with the usual nausea, lots of sleeping, and eating.

From what my doctors tell me, it typically takes several weeks for the new marrow to fully graft into my body. During this time, the cumulative effect of the chemo I've been given (Busulfan, Cytoxan) begins to lower my blood counts until I've becomes "neutropenic," meaning there is an abnormally low concentration of neutrophils (a type of white blood cell) in the blood. Neutrophils make up the majority of circulating white blood cells and serve as the primary defense against infections by destroying bacteria, bacterial fragments and immunoglobulin-bound viruses in the blood. To put in pirate terms, take down the defenses and the ship is ripe for the plundering, or in my case grafting.

The grafting process is quite interesting. During this process, I'll be given meds to help suppress the body's normal defenses in order to help receive the foreign marrow. Minor to extreme rejections are what is called graft vs host disease. This could be as minor as skin rashes to as major as organ failure.

I'm reminded of the passage in Romans 11, where Paul talks about the grafting in of Gentile believers with the Jewish believers, all through the power and work of Christ. In order for a foreign material to be received and partake in the benefits of the natural plant being tied into the root, it takes an outside work of God for this to occur. The same could be said of my bone marrow transplant.

¹¹ So I ask, did they stumble in order that they might fall? By no means! Rather, through their trespass salvation has come to the Gentiles, so as to make Israel jealous. ¹² Now if their trespass means riches for the world, and if their failure means riches for the Gentiles, how much more will their full inclusion^[b] mean!
¹³ Now I am speaking to you Gentiles. Inasmuch then as I am an apostle to the Gentiles, I magnify my ministry ¹⁴ in order somehow to make my fellow Jews jealous, and thus save some of them. ¹⁵ For if their rejection means the reconciliation of the world, what will their acceptance mean but life from the dead? ¹⁶ If the dough offered as firstfruits is holy, so is the whole lump, and if the root is holy, so are the branches.
¹⁷ But if some of the branches were broken off, and you, although a wild olive shoot, were grafted in among the others and now share in the nourishing root^[c] of the olive tree, ¹⁸ do not be arrogant toward the branches. If you are, remember it is not you who support the root, but the root that supports you. ¹⁹ Then you will say, “Branches were broken off so that I might be grafted in.” ²⁰ That is true. They were broken off because of their unbelief, but you stand fast through faith. So do not become proud, but fear. ²¹ For if God did not spare the natural branches, neither will he spare you. ²² Note then the kindness and the severity of God: severity toward those who have fallen, but God's kindness to you, provided you continue in his kindness. Otherwise you too will be cut off. ²³ And even they, if they do not continue in their unbelief, will be grafted in, for God has the power to graft them in again. ²⁴ For if you were cut from what is by nature a wild olive tree, and grafted, contrary to nature, into a cultivated olive tree, how much more will these, the natural branches, be grafted back into their own olive tree.