Science Fiction / Double (Cord Blood) Feature

The Rocky Horror Picture Show's got nothing on me.

Yesterday was my 11-month post-transplant check-up. My doctor informed me my blood work is 100% normal, but when you're a freak of nature, what's normal? He handed me a copy of my Dual Cord Molecular Chimerism Report which shows the numerous chimerism analyses done on my blood/marrow since my transplant. If I can explain this and you can understand it, I think I deserve a prize, possibly a Pulitzer.

A hematological chimerism test shows the genetic composition of your blood. Your garden variety stem cell transplantee will have no more than two blood lineages, the donor's and their own. A double cord blood transplantee is more in line with the original Greek mythological Chimera, a three part fire-breathing beast composed of a lion's head, a goat's body and a serpent's tail. However, 70% of cord blood transplantees experience a rejection of one of the cords (see Androids fighting) and end up with blood cells from one donor. The other rather non-darwinian 30% retain both grafts, which for unknown reasons appear to have signed a peace pact. The percentages of each cord vacillate over time. My cords, one from a boy born in Australia on May 5, 1999 (cord #1), the other from a boy born in Colorado on October 14, 2000 (cord #2), have been ranging from 32%/68% to 47%/53% with the most recent analysis (July 2008) showing 46%/54%. This adds up to 100% donor, but it is an analysis of the granulocyte lineage only. Granulocytes are a type of white blood cell which fight infection. For what it's worth, you will note that I have cells born in both the second and third millenia. Time warp, anyone?

Interestingly, the chimerism test is performed not just on granulocyte cells but on T-cells as well. T-cells are white blood cells that form the basis of our immune system and can live for decades. Tucked away in the spleen, the lymph nodes or wherever these babies hang, they actually remember past assaults on the body and spring into action as needed. I'm telling you all this because apparently, the pre-transplant chemo that annhilates the blood cells doesn't necessarily take out all the T-cells. The ones that survive are obviously savvy in the extreme. Chimerism analyses of my T-cells has shown that I still have a number of these ancient lurkers in my bloodstream, anywhere from 62% (December 2007) to 22% (July 2008). The remaining percentage are donor T-cells.

If you've followed this so far, a gold star is placed on your virtual nameplate.

I asked my doctor what all this means in terms of my ability to fight disease, and more importantly, stay in remission. It's possible my immune system will have superhuman powers. It's also possible the menage a trois will bicker and precipitate a battle royale. My doctor admits there's just not enough data to predict what will happen. I, it appears, am the data.

To summarize: I have 3 different kinds of DNA, fodder for a CSI episode, sci-fi novel or horror movie musical. I have 3 birthdays, a serious complication as far as my astrological chart goes. I mean, what is my sign? I have both XX and XY chromosomes, a condition that may or may not be covered by my health insurance. It appears I am Brad and Janet.

Don't dream it, be it.