Ray was admitted today at NIH to prepare for apheresis.

Apheresis is the first step in preparing for gene therapy. During apheresis his own stem cells are collected and will later be treated with a vector carrying a segment of DNA which is designed to correct his immune deficiency. Apheresis requires that a large IV line be placed, because they draw off his blood, separate out the cells they want, and then return the rest of his blood back to him. In Ray’s case, the line placement is tricky. He’s had so many central lines over the years his veins have become filled with scar tissue and in many areas collateral veins have expanded to carry blood flow. However, these collateral veins are not large enough to handle a large IV line. The Interventional Radiologist is going to have to place the line in Ray’s lower back. This is planned for Wednesday morning. Once the line is in place he will be sent to the Apheresis Lab where his stem cells will be collected. All weekend Ray has received GCSF, a drug which causes his bone marrow to work harder and produce more than his usual number of cells. This should make the collection process more productive.

Today was a day of getting everything in order. TPN had to be ordered (Ray’s IV nutrition), as well as all his meds and enteral formula. It’s been a typical admission day with a revolving door of people in and out of the room. It’s finally quiet in the room and Ray has his computer, phone and TV all going.