Like A Newborn: Recovering From a Bone Marrow Transplant 

 In Patient Experiences

When students come into Ms. Marlowe’s classroom, like many students returning to school, they take precautions. While COVID protocols are something many are familiar to now, her students and their families take extra care and pride to help protect what Ms. Marlowe is caring for at home a “newborn.”

Married in late 2019, a baby was something the Marlowes had hoped for, but when Ms. Marlowe’s husband, Brett, fell ill on their honeymoon, their plans for the future had to be put on hold. We first caught up with Brett Marlowe in September of 2020, just one year after his leukemia diagnosis. He describes his experience: 

Q: What was your first thought when you received your leukemia diagnosis?

Brett: Eleven days after our wedding, I was diagnosed with acute lymphoblastic leukemia (ALL). It was pretty devastating at first. We were faced immediately with some heavy things fertility issues being one. We’re starting out our marriage with a lot of challenges some people never face. In the first six months of our marriage, I spent more time in the hospital than I did at home, which was very challenging as newlyweds. 

Q: Where are you in your leukemia treatment?

Brett:  Leukemia has a reputation for mutating, and relapses are very common. I began treatment with a prescribed regimen of eight chemotherapy cycles. I went through four cycles and was in remission. Then a bone marrow biopsy revealed that my ALL had begun coming back, so my doctor put me on immunotherapy treatments, two 30-day infusions.

Q: What has meant the most throughout your cancer treatment?

Brett:  We’re people of faith and our faith has definitely been strengthened through this. Everyone has been so understanding and supportive. Lots of friends will call and encourage us. We’ve got friends all over the world, and social media has been helpful as we send out posts and updates about what’s going on with me.

My wife is a kindergarten teacher, and her school-family has been great to us as well. We were very careful to avoid germs because of my chemo treatments, but even more so since COVID. 

Q: Is a bone marrow transplant next?

Brett:  I’m in what they call molecular remission following the immunotherapy infusions and they’re preparing me for a bone marrow transplant. ALL is an aggressive type of leukemia that is often treatable, and in some cases, even curable. We’re praying a bone marrow transplant will actually cure me. 

To prepare for the transplant, I’ll undergo six rounds of full-body radiation even though I’m in remission. Then in early October they’re planning to admit me into the hospital for a week of conditioning prior to the actual transplant date.

Q: How has Personalized Hematology/Oncology been involved?

Brett:  About two months prior to my diagnosis, I had been having leg cramps and was referred to Dr. Castillos for treatment of deep vein thrombosis (DVT). When we returned from our honeymoon, I immediately called him. He began running labs and had me admitted to the hospital for severe anemia. It was Dr. Castillos who diagnosed me. It’s thought now that the DVT was a precursor associated with the ALL. 

Dr. Castillos is still very involved. His office runs regular labs and keeps the detailed aspects of my bloodwork managed, such as potassium, magnesium and iron levels. He’s really ensured my quality of life throughout this treatment. I feel like I’m in the best possible human hands with him.

 

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“Newborn” immune system

We checked in with Brett again in late January of 2021 as he approached his 100th day milestone following his bone marrow transplant, and his “newborn” immune system is doing just fine. The six rounds of radiation prior to the transplant were to ensure that Brett’s biological immune system was diminished to the point that his transplant could take hold. His doctors described this to him as having a newborn to care for.

Just like with infants, Brett has to follow a very strict diet. His food must all be cooked, even seasonings, and fruits that need to be peeled are off the menu. He’s still seeing his doctor two to three times a week, but despite all that, he feels a growing sense of normalcy. He’s had his chemo port removed, and his preliminary results look good. Brett received one final set of results that allowed doctors to reduce the amount of anti-rejection medication he’s on and move down to one appointment per week – appointments that he will finally be able to drive to himself!

Life after a bone marrow transplant

Brett will have to be completely reimmunized! The hardest part of his treatment to date, he shares, his bone marrow transplant has taken three months as he works to get his energy back up. But after a full 31-days in the hospital undergoing radiation and its side-effects in addition to having his immune system wiped out, Brett is ready to come back stronger. Looking forward to having his diet restriction lifted, he and his wife hope to get back to the healthy lifestyle they enjoyed before his appetite was wiped out by treatments. At six months, Brett can go down to one doctor’s appointment per month. He will need to receive his six-, 12-, and 18-month vaccinations again and will remain on precautionary medications for an additional six months to ensure he’s fully protected.

Brett and Ms. Marlow pose together just before his bone marrow transplant in October.

After that? There’s talk of a honeymoon do-over, and the couple took precautions early in the diagnosis to preserve their reproductive options, so an actual newborn could be in the cards for the Marlowes. However, the couple is prepared for whatever lies ahead. Brett has recorded his journey in a 250-page memoir that he hopes to publish one day.

Cancer treatment options in the Triangle

Brett still goes to Dr. Castillos whenever something in his body “just doesn’t feel right.” The on-site infusion suite at Personalized Hematology/Oncology has been a haven for him during his treatments where he feels like a person instead of a number and diagnosis. Brett says he appreciates how Dr. Castillos is always right there, as he has been from the very beginning, to make sure that Brett’s quality of life is as good as it can be while he and his wife turn to face the next challenge marriage holds for them.

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