Stem-cell transplant complete, wait begins for Jonathan Pitre

The perilous wait now begins for Jonathan Pitre.

Pitre, 16, was transfused with blood and marrow drawn from his mother’s hip late Thursday afternoon. The stem-cell-rich material holds the power to alter the course of Pitre’s aggressive skin disease, epidermolysis bullosa (EB), and change his life.

“So far, so good,” said Pitre’s mother, Tina Boileau.

It will be several weeks before Pitre finds out whether the transplant has worked its magic.

While waiting for that answer, the Russell teenager will have to travel the most difficult part of his medical journey: a time when his immune system is at its lowest ebb, and when he feels the full effects of high-dose chemotherapy and radiation.

His physician, Dr. Jakub Tolar, has warned that the period represents “the highest risk for complications,” the most common of which are infections and graft-versus-host disease (GVHD). It is a potentially life-threatening situation in which the implanted stem cells produce T-cells that attack normal cells.

In about two weeks, doctors will start to look for signs that Boileau’s stem cells have successfully established themselves in Pitre’s bone marrow. The presence of white blood cells is one of the earliest signs of stem-cell growth; an improvement in the condition of Pitre’s skin could also signal that the stem cells have started to work.

Last year, after his first stemcell transplant, Pitre and his mother were thrilled when doctors discovered new white cells in his bloodstream. But their hopes were crushed when tests showed that his own stem cells had recolonized his bone marrow, and were producing the cells.

“I think we will have that uncertainly until we know for sure through skin and bone marrow biopsies that the engraftment worked,” she said.