Hi @lorieliebrock It looks like everything is falling into place with your upcoming BMT! Having 2 10/10 matches for a donor is excellent. My 20 year old donor was from the US as well, and ‘he’ has served me well for the past 7 years 😂.

As for how much weight you might lose, of course that varies for everyone. From the time I started treatment for AML up to my transplant date (4 months) I had lost about 40 pounds. Before being diagnosed, I had been fluffy with extra menopause pounds for years, but even a 40 pound loss was significant. The loss was attributed to the cancer, which is a calorie eater and the chemo. However, before my transplant, which would be 2 months away, my doctor wanted me to gain back at least 15 pounds. I struggled! I had no taste buds and was nauseated all the time. But I managed to gain 12 and my BMT doctor felt that was ok.

After transplant, well, let’s say, I certainly got into my skinny girl jeans. I lost that 12 pounds plus probably 10 more. That elicited comments from my team, like “Get that girl a cheeezburger!” LOL.
The first few weeks being the challenging time when you don’t feel like eating due to some nausea, fatigue, etc. You’ll be encouraged to eat proteins, protein shakes, and CALORIES. They don’t care how you get them. The key is calories and protein if you can! So my husband found Lactaid ice cream! It was what finally helped put meat on my bones…he made smoothies with that as a base, I ate it in cones, in a dish…The Salted butterscotch was excellent and being lactose free it doesn’t bother the gut.

Your other question about the current damage the fibrosis does to the marrow and how that will impact the transplant. You’ll be receiving preconditioning chemo which will clean out your marrow, ensuring remaining cancer cells are gone and it is a chance for a remodeling of the marrow. The day after the last chemo day, there is a day of rest and fluid flushing. Then day Zero is transplant day. The newly harvested cells will be infused via your port, just like a transfusion. Takes about 15-30 minutes. Pretty anticlimactic.
The cells will circulate in your blood stream tumbling along the walls of your veins until they find these little ‘magic’ portals into the bone. (Pores really). Anyway, once the cells nestle into the bones, (engraftment) they begin to mature into functional blood cells and become your new immune system. It’s such an amazing process!

Once engraftment occurs, healing and recovery begins in earnest. At that point generally you’ll start incrementally feeling better daily, your strength and endurance will pick up and you’ll feel more like eating.

So, between now and transplant it would be helpful to put on a few pounds. I know you’ve struggled to lose the weight in the past and it feels counterintuitive and off-putting to intentionally gain weight again. From my experience, those extra pounds will be lost! But for the time being, they are a safety net for the calorie deficit to come. So this is one time you can splurge on calories. It doesn’t mean you’re retreating into past negative eating habits. Trust me. Those will abruptly change with the transplant. So you’ll be starting fresh and can be mindful of starting a new healthy eating plan. But for now, it’s time to add a little fluff. ☺️