Robin Roberts is Back! What It Took to Get Her There

Five months to the day after her bone marrow transplant, Robin Roberts was back at the anchor desk on Good Morning America.

Roberts, 52, underwent the bone marrow transplant on September 20, to treat Myelodysplastic Syndrome (MDS), which was a complication of the treatment she received for breast cancer in 2007. Her sister, Sally Ann Roberts, an anchor for WWL-TV in New Orleans, was an excellent match, and became the bone marrow donor.

Before the actual procedure, Robin Roberts had to undergo 10 days of intense chemotherapy. This was done to remove any abnormal cells from her body before the new immune cells are introduced. This came with all the typical side effects of chemotherapy- raw throat, achiness, weakness and headaches.

Of the day of the actual transplant, Roberts told People magazine she remembers very little- although she does recall seeing her transplant specialist, Dr. Sergio Giralt at Memorial Sloan Kettering Cancer Center, say a prayer as he injected the stem cells into her chest catheter. “I loved that he prayed,” she said.

Afterwards, Roberts came to a near breaking point:

I was in a pain that I had never experienced before, physically and mentally. I was in a coma-like state. I truly felt I was slipping away.

Fortunately, this period ended, and she slowly began to see improvement, measured in how many laps she could walk around the nurses station.

When she finally went home on October 11, Robin was excited to be home, but worried about leaving the “safety” of the hospital environment. She had to wear a surgical mask everywhere (even in her apartment) to protect her new immune system from infection. Her red blood cells were also low, which made her weak. Her muscles had atrophied and her appetite was almost nonexistent.

In November, she contracted a virus called CMV (cytomegalovirus), which put her back in the hospital. It took 6 weeks to clear the virus. Although things have shown continued improvement, her oncologist, Dr. Gail J. Roboz says “we’re not out of the woods yet. Robin’s immune system is like a 5-month-old baby’s. She’s very vulnerable.”

Over the past few weeks, Robin has been “in training” to get her body ready to return to GMA. She’s had to become re-accustomed to getting up at 3:45 am. She’s gone through a few “trial runs” at the office, and she will probably only work a few days a week for a while.

It was nice to see Robin on GMA this morning, her smile raising the spirits of all those who have been inspired by her journey. As she told People:

I want to give people hope. I want to let them know there is another day. I can be fearful or fearless. I choose to be fearless.

Post Bone Marrow Transplant Recovery

As Robin Robert’s story illustrates, the road to recovery after bone marrow (or stem cell) transplantation is long and fraught with danger. There are 3 main things that must be carefully watched:

1. Prevention of infection
2. Monitoring for Graph-vs-host Disease
3. Nutrition

1. Prevention of infection

Bone marrow transplant patients need to take care not to get infections for up to 1 year or more after a transplant.

Practice safe eating and drinking

• Be careful what is eaten. Do not eat or drink anything that may be undercooked or spoiled.
• Make sure drinking water is safe.
• Know how to cook and store foods safely.
• Be careful when dining out. Do not eat raw vegetables, meat, or fish, or anything else you are not sure is safe.

Wash hands with soap and water often:

• After being outdoors
• After touching body fluids, such as mucus or blood
• After changing a diaper
• Before handling food
• After using the telephone
• After doing housework
• After going to the bathroom

Be careful with pets and animals.

• If you have a cat, keep it inside.
• Have someone else change the litter box every day.
• Do not play rough with cats. Scratches and bites can get infected.
• Stay away from puppies, kittens, and other very young animals.

Other important measures:

• Keep your house clean.
• Stay away from crowds.
• Ask visitors who have a cold to wear a mask, or to not visit.
• Do not do yard work or handle flowers and plants.
• Oral hygiene is very important- brush and floss carefully.

2. Monitor for Graft-vs-Host Disease

The immune system is the body’s tool to fight infection and disease. It works by seeing harmful cells as “foreign” and attacking them. A donor’s stem cells (known as the “graft”) job is to recreate the donor’s immune system in the recipient’s (“host”) body.

Graft versus host disease (GVHD) is the term used when this new immune system attacks the host’s body. Donor’s cells see the host body as “foreign” and attack it–causing damage. GVHD can be acute or chronic.

Acute GVHD usually occurs within the first 100 days after a transplant. Acute GVHD commonly affects:

• skin
  • red rash
  • itching
  • darkening of skin
• liver
  • elevated liver tests determined through blood tests
  • yellowing of the skin and whites of the eyes
  • abdominal pain (later symptom)
• gastrointestinal (GI) tract
  • watery diarrhea
  • stomach cramps (especially before and during bowel movements and after eating)
  • persistent nausea

Chronic GVHD can happen 100 days after transplant, but it can occur as early as 60 days post-transplant. Chronic GVHD can reoccur for several years after transplant.

3. Diet

Most patients lose weight during the chemotherapy and bone marrow transplant process. Good nutrition is a very important part of recovery, helping the body resist infection and repair tissue damage caused by chemotherapy and/or radiation therapy.

Over-the-counter nutrition supplements can provide additional calories and nutrition. Examples of this include Ensure®, Boost®, Resource®, and Carnation Instant Breakfast®.

Multivitamins as well as calcium supplements are usually recommended as well.

Sources: National Bone Marrow Registry, Medline Plus, and National Cancer Institute