Part 2

In October I had another PET scan in Omaha and it showed five lymph nodes with cancer in them. Another bone marrow sample was taken and my Doctor said a stem cell transplant would be a failure because I still/already had cancer back in my body. He recommended a procedure called a CAR-T transplant. I agreed to the change and he sent me home to rest until it could be scheduled.
Now it is October 16, 2019, and I return to Omaha. A catheter is placed in my neck vein, blood is sucked out and run through a centrifuge to spin it and separate the large red T cells from the rest of the blood. It took four hours to circulate my blood three times thru this “cream separator” centrifuge to get about a quarter of a cup of T-cells. (the cream separator looked like the R2-D2 robot in the Star Wars movies) These T-cells were taken to a laboratory in California where they were genetically modified to attach to the cancer protein. It took them three weeks to grow and multiply them until they had a cup size volume of them. Then they were returned to Omaha.
Before the cells were returned, I came back to Omaha and took another three days of another chemotherapy cocktail in the Cancer Center. After one day of rest the modified T-cells were infused back into my blood system. I spent the next fourteen days in isolation and under observation to watch for infection. I was also quizzed twice daily to measure for changes in cognitive response. This would indicate a cytokine storm to them.
Another two weeks of outpatient daily exams and I was deemed healthy and safe enough to return to Paullina. To monitor my transplant response I had blood tests twice weekly. If any test showed my white blood cells dropping below a set amount I had to get growth factor shots for three successive days. I got several of these regiments over the course of my battle.
December 16, 2019, I came home from Omaha. January 2, 2020, I had a check-up with my Sioux Falls Doctor. That was 51 days after my CAR-T transplant. That day was important as a measure as to or not I had any side effects of a cytokine storm the doctors were watching for. A cytokine storm is a severe immune reaction in which the body releases too many cytokines into the blood too quickly. Cytokines play an important role in normal immune responses, but having a large amount of them released in the body all at once can be harmful. A cytokine storm can occur as a result of an infection, autoimmune condition, or other disease. It may also occur after treatment with some types of immunotherapy. Signs and symptoms include high fever, inflammation (redness and swelling), and severe fatigue and nausea. Sometimes, a cytokine storm may be severe or life threatening and lead to multiple organ failure. It is also called hypercytokinemia.
I had no immunity to infection. I was ordered to isolate and quarantine myself until my white cells in my blood returned to normal. Three months later the Covid-19 isolation began and I had already been practicing, so it was easy for me.
On January 22, 2020, I returned to the Omaha Cancer Center for a Pet scan to see if I had any cancer again in my body. My case worker, Stacey, came in the exam room gushing and smiling and overjoyed to tell me Dr Boicek was coming to report on my Pet scan results. Stacey said she couldn’t tell me the results but she could tell me I would be very happy once I got them from Dr. Boicek. His report was “no cancer present.”
Over the next 18 months, I slowly regained weight and health. I went from a low weight of 154 pounds up to 180 pounds. My blood tests got back into normal levels also.
The cancer leaching my bones caused them to shrink and I lost four inches of my height during my battle. I doubt that I will ever regain that height.
During my ordeal I had several community friends be a taxi to get Sheila and I to Sioux Falls and to Omaha several times when I needed help. I also received many cards of encouragement and well wishes from community people during my battle.
My CAR-T transplant was quite new for treating Non-Hodgkins Lymphoma. My doctors tell me they do not know how long it might be effective but if I live five years they feel I will have beaten the cancer. They also tell me that since my transplant they have three new procedures to treat me with if and when the cancer does return. All of these treatments are the result of research and the mRNA technology. This mRNA technology is what so quickly brought the world the vaccines we have for Covid-19.
Recently, I saw a news report from two persons who were the first people given this CAR-T transplant. They have lived ten years now and believe to be fully cured.
This page tells the story of another patient that received CAR-T for her cancer.
This page is a story of testing CAR-T in mice to study the effect on cancer.
Bruce Billick

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