Day 83
Today was another weekly clinic visit and the good news is that my counts were up, especially my white blood count (which is now in the normal range again).
WBC – 6.5
Hgb – 12.7
Plt – 197
The doctor still doesn’t know why my WBC plummeted like it did and we can’t be sure whether the Neupogen I’ve been taking is the only reason it went back up like it did or whether it would have gone up some anyway. I took the Neupogen 3 times last week and this week, he is cutting it back to twice. If the WBC stays high enough, he will cut back even more next week and hope soon to get me off it completely.
I’ve had some bone and joint pain plus a bit more tiredness, both of which are probably due to the Neupogen. I’ve also had a bit of an upset stomach, which could be some GvHD, or could be due to the Neupogen as well.
Now that I’m getting close to 3 months post transplant (which will be next Friday), the doctor is expecting more GvHD. He explained that with the old fully ablative transplants that they used to do, they saw a lot more GvHD within the first 3 months because the more intensive chemotherapy did more damage to many organs which left pieces of those organs all through the body and blood. This meant the antibodies from the new immune system could find and attack those pieces more easily, and when they were done with the pieces, the antibodies were all worked up and they then attacked the organs themselves. This, of course, is my translation of what the doctor said, but it gives the general idea. With the mini transplant like I got, the chemotherapy is less intense and does less damage to the organs, so the antibodies take longer to mobilize and attack the more healthy organs. This means that more often with the mini transplant, the GvHD comes after 3 months post transplant.
The doctor also said that I am a high risk patient in part because the stem cells used came from a female donor (which doesn’t at all imply that I am anything but totally grateful to my wonderful sister for donating the stem cells). Because of the relatively high risk, he may taper off my anti-rejection drug a bit more slowly over the next several months. He has to try to balance the need to get me off the drugs with the danger that doing so too quickly could cause severe, even fatal GvHD reactions.
In the meantime, I’m hanging in and doing OK.
Love,
Justin
WBC – 6.5
Hgb – 12.7
Plt – 197
The doctor still doesn’t know why my WBC plummeted like it did and we can’t be sure whether the Neupogen I’ve been taking is the only reason it went back up like it did or whether it would have gone up some anyway. I took the Neupogen 3 times last week and this week, he is cutting it back to twice. If the WBC stays high enough, he will cut back even more next week and hope soon to get me off it completely.
I’ve had some bone and joint pain plus a bit more tiredness, both of which are probably due to the Neupogen. I’ve also had a bit of an upset stomach, which could be some GvHD, or could be due to the Neupogen as well.
Now that I’m getting close to 3 months post transplant (which will be next Friday), the doctor is expecting more GvHD. He explained that with the old fully ablative transplants that they used to do, they saw a lot more GvHD within the first 3 months because the more intensive chemotherapy did more damage to many organs which left pieces of those organs all through the body and blood. This meant the antibodies from the new immune system could find and attack those pieces more easily, and when they were done with the pieces, the antibodies were all worked up and they then attacked the organs themselves. This, of course, is my translation of what the doctor said, but it gives the general idea. With the mini transplant like I got, the chemotherapy is less intense and does less damage to the organs, so the antibodies take longer to mobilize and attack the more healthy organs. This means that more often with the mini transplant, the GvHD comes after 3 months post transplant.
The doctor also said that I am a high risk patient in part because the stem cells used came from a female donor (which doesn’t at all imply that I am anything but totally grateful to my wonderful sister for donating the stem cells). Because of the relatively high risk, he may taper off my anti-rejection drug a bit more slowly over the next several months. He has to try to balance the need to get me off the drugs with the danger that doing so too quickly could cause severe, even fatal GvHD reactions.
In the meantime, I’m hanging in and doing OK.
Love,
Justin
1 Comments:
Sounds like you're completing the first phase pretty well, although it must be a bit scary to be waiting to see how bad the GvHD will be. It's great to know how you're doing from your posts and to know the doctors are taking such good care of you - much better than we could even though we love you so much more than they can. You can tell them I say "thanks" for doing such a commendable job!
Much love,
Wayne
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