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Allopurinol and how do they test a brother for stem cell match

Morning all,

I was Dx 2 months ago and have been on Allopurinol since as well as Glivec 4 weeks. Went to GP the other day ( unrelated appointment ) and he was a little surprised I was still on the Allopurinol, saying that he’s obviously not an Oncologist. My question ; how long are we usually on it for. Seeing specialist this week so wanted to have a little background info.

Also Glivec seems fine, little side effects thankfully, however I have a brother and was wondering when they would test for a donor match and how he is actually tested. Eg does he have a bone marrow sample, blood test or what. I realise and hope it’s unlikely he will be needed but there are a few personal reasons I would like to know if he’s a match sooner rather than later

Thanks keep well all.    Nigel

Hiya Nigel,

I can't quite remember how long I was on Allipuinol when first diagnosed, I think it was a few weeks.

As for testing your brother to see if he is a match it is just a simple blood test for you both, they take a blood sample of each of you and the results normally take a few weeks to come back. There is a 1 in 4 chance of a sibling being a match.

Hope that helps

Jackie

Hello Nigel  

Allopurinol helps bring the white cell count down, not sure how long I took it for - about 4 weeks I think. Wonder where in the country you are? There are CML specialist centres around the country and its a good idea to get an appointment at one.  This way you, and the hospital treating you, get the best advice on treatment and options. Many CMLers do share care with local hospital and specialist centre, this way you get the best of both worlds.

Checking for a match is quite simple for both of you initially, just a blood test that is checked for all the necessary matchpoints. Mine sister had a test to see if she was a match for me about 3 months after diagnosis.

All the best

Pennie. 

Nigel,

 

I'm a little surprised too you've been on allopurinol for that amount of time, although from my experience that's not excessive. I think i was on it for 4-5 weeks overall. Allopurinol reduces your uric acid levels, which are elevated in CML due to a turnover of blood cells - i seem to remember when you take the gleevec or hydroxurea the rapid reduction in white cells can elevate uric acid levels - although i could be wrong. I suspect your specialist will take you off the allopurinol at your appt this week - assuming your counts are normal and uric acid levels are back to normal. 

as for stem cell transplant compatibility testing, have a look at: http://www.surgeryencyclopedia.com/Fi-La/Human-Leukocyte-Antigen-Test.html

it appears HLA testing is a simple blood test, so nothing too invasive, although i'm sure your specialist will advise if anything else is required.

Chris 

Hi Nigel... allopurinol - I was taking this for around 3 weeks following start of 400mg imatinib. so as Chris says you will probably be taken off this very soon as long as your white cell count is normalish.

HLA matching for donors is an easy test which only requires them to give a blood sample. Should they be a good match and agree to donate their stem cells, then that is a different matter.

They will be required to inject a drug once a day for around 5 days to force their marrow to produce a high rate of white cells including stem cells, which will then be taken off via a machine in a process called  Leukopheresis-

which means they will spend a pretty boring day spent in the clinic with i.v's in both arms---- blood is taken from one arm -enters a centrifuge in which the cells are separatedof - stem cells and mature leukocytes are harvested- the rest -red cells/platelets etc are given back to the donor via the other arm. Sugary tea and biscuits for an hour- then home.

the donation is then 'refrigerated' in case they are needed in the future. 

But- given the extremely impressive success rate for TKI therapy in CML, this insurance of harvesting cells for SCT is not often done. The storage of such cells for possible future use is expensive- and in most cases of chronic stage CML will never be used- unless of course you elect to go down the sct route.

Hope this helps,

Sandy