Andrea Zwarich: My Experience with
Receiving an Allogeneic Stem Cell Transplant
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To date, I have lived a pretty amazing life; a dream career in therapeutic animal assisted interventions which stemmed from my previous experiences in working with horses and teaching riding. I am the single parent of an amazing young teenager who is an aspiring competitive gymnast and fully invested in his high school academics.
Towards the end of 2014, at age 37, I began to experience extreme fatigue and worsening pain in my hip. Thinking that it was stress-related and perhaps a sign that I needed more physical strength, I commenced weight training and chiropractic sessions. By March 2015, I could barely walk, lift a saddle on a horse, or throw any hay bales, but I continued to do so thinking it was just ‘wear-and-tear’ and that I needed a bit of a break. During a chiropractic treatment, I nearly passed out due to excruciating pain in my rib cage.
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At the end of April 2015, I was asked to make my way to the emergency as my blood calcium was at a dangerously high level. Upon admission, I collapsed in pain and it was discovered through tests that I had more rib fractures than I could account for and my hip was at risk of shattering due to the lesions. I was finally diagnosed with multiple myeloma an incurable but treatable cancer of the plasma cells found in the bone marrow. I was immediately hospitalized and admitted at Royal University Hospital in Saskatoon and two weeks later in the Bone Marrow Transplant unit. I was very scared, and my first thought was, “Is this where they send patients who are about to die?”
I learned how rare it was for a woman my age, under 40, to be diagnosed with myeloma. This is often why younger patients experience delays in diagnosis as it is not on the radar for many family physicians when a young athletic woman presents symptoms associated with this disease.
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I began induction therapy in preparation for an autologous stem cell transplant and it was made clear to me that although multiple myeloma was treatable, my life expectancy was 10 to 15 years if I was lucky. I tried to push through with my boldest and bravest self and I began my first treatment on dexamethasone which gave me bursts of energy and crashes and aggravated my emotions. However, in June 2015, I learned from cytogenetic testing that my multiple myeloma was considered high-risk. I was offered the option of undergoing an allogeneic (allo) stem cell transplant. Without this transplant, my life expectancy was only 2 to 3-years. The goal of an allogeneic transplant is to cure the disease; however, this is not standard of care in Canada due to the very high risk of complications.
I had a difficult and deeply personal decision to make. I had a teenage son to raise, so in the end, I opted to go for the allo transplant. After much discussion and reflexion, I chose to proceed with the most aggressive option: Chemotherapy, followed by an autologous and allogeneic stem cell transplant (known as a tandem “auto-allo mini”).
During my chemotherapy leading up to my first autologous transplant, I experienced side effects including nausea, vomiting, fatigue, hair loss, reduced stamina and low blood count resulting in an immunocompromised state. Because of the steroids, I also experienced anxiety, insomnia, and mood swings.
My family and I were coping with a highly stressful situation so I proactively reached out to my medical team for support, including our Clinical Oncology Social Worker. I kept my team abreast of the psychosocial stressors in my life, which became cumulative.
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There was a sudden change in my personal situation that occurred in June 2015 and I was becoming very aware that I was not going to have a home to return to. I was very weak and could barely keep up with the basics of living, let alone moving out of my home.
Post-allo, I went to my mother’s house to receive the 24/7 care requirements and to be with my son. My mother was my hero in maintaining a sense of normalcy for my son. Recovery from an allo transplant is very different from an auto transplant. The weakness and fatigue felt are indescribable. It took me well over a year to get through a day without napping and not have sometimes up to 16-hour sleep marathons. The brain fog and memory losses are very frustrating. I lived from blood transfusion to blood transfusion for quite some time. I hid a lot from my friends and family and tried to be as present as possible for my son.
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Andrea Zwarich with her mother and her son
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At about 120 days post-treatment, my blood work appeared to be showing that the allo was working. A bump had formed on my hip, however, and it was becoming increasingly difficult to walk. I later learned that my hip was fractured. My disease relapsed in August 2016 and this was devastating. I thought that the allo had failed and it was not looking good. It was a very chaotic time. In the process of moving into a house of my own, trying to give my son a summer vacation and preparing to take Grad studies to claim my victory, the pain grew so great again that I was admitted back into the hospital’s Bone Marrow Transplant Unit. I was put on high-dose pain management therapy, chemotherapy, and high-dose dexamethasone. I started radiation treatment for the lesions in my hip and I thought it was the end of my life.
In my mind I thought, “I AM NOT GOING OUT THIS WAY.” Yet somehow in November 2016, my donor stem cells began to fight back, and I was working myself towards remission.
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I tried to return to work part-time to try to buffer the financial strain of increased costs of living as a single mom and carrying a student loan debt on a reduced income, but unfortunately due to my health situation, I was unable to continue. The return to work plan was precarious and I learned employment assistance plans eventually run out and are not set up for an aggressive cancer battle. After many trials and tribulations, learning that my benefits were going to be cut off, my rental suite was going to be sold, and after several moves and having to live out of suitcases, the dust began to settle, and I was finally able to find a more suitable rental space for my son and I.
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Andrea Zwarich and her son
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Remarkably, my son continues to get good marks and continues to pursue training as a competitive gymnast. He is my hero and I am so proud of him. I am so grateful that my allogeneic transplant now has me in remission and I am hopeful that this time of stability will help me heal. Two years post-allo, I am seeing more glimpses of the Andrea that I knew and loved. I do not know if I will work again and for now, I continue maintenance therapy. There have been times where I have been able to dance and ride horses.
Has my decision to undergo an allogeneic stem cell transplant been worth it? Yes. MY SON HAS A MOM!
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Alas, I recently experienced a funny twist of fate after all I have gone through. To put it into context, I won the lottery of life by having two sibling donor matches for my allo transplant. One sister is allergic to animals and horses, and the other to peanuts. My medical team chose the sister with the peanut allergy as my donor since allo-patients can sometimes inherit the allergies of the donor.
Two years and one day after I received my sister’s stem cells, I accidentally ate a cookie with peanut butter in it. I had a severe allergic reaction and my throat began to close. I was in emergency in anaphylactic shock - I sure know how to celebrate!
My new normal is so different and while it may sound unbelievable, it is true. Trust me, I have learned to believe in the unbelievable, to hope, when all hope is shattered and to love, when all love is absent. Somehow, I make it look easy when I am not even sure how I am here. I am grateful to be writing this for you, and thank the professionals and patient community who continue to bring awareness to multiple myeloma.
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To find a local support group in your area or for information on how to start one,
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