The chimerism test came back. He is 95% engrafted in all cell lines. This was great news but it does not exactly mean all cell lines, because his RBC have not converted yet. That's a different topic.
The bad news, his skin GVH flared-up so he is back on 1ml/steroid/every day. The Prograf level was 4.5, so the amount I give him was increased to 2.2m/twice/day. The rash is doing much better today.
Dr. Argawal is calling his sking GVH "systemic." She thinks the lack of his blood type conversion is due to the "systemic" skin GVH. I tend to disagree. We've read reports that talk about delayed blood type conversion when the receipient has a non-myleoablative pre-conditioning. That's what David had. It was less toxic pre-conditioning and with it comes delayed engraftment. Also, I have known people who've had delayed conversion - up to 19 months! I told Dr. Argawal I'm happy with just waiting for the conversion. She agreed...I think. She is a hard person to communicate with. She says one thing but means another. She does not communicate clearly or use enough technical jargon for me. Getting technical information from her is like pulling teeth. It's often too difficult for me, so when the other BMT doctors take over his care (they rotate), that's when I get my questions answered.
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Aimee,
SOrry to here the rash flared up again. I know how much you must want David off of steroids Probaby as much as I want JAcob off.
Help! What does systemic GVH mean? I thought that most GVH could create systemic problems -- i.e. immune system not developing as well and low numbers. Is this soemthing different? I am just wondering by JAcob seems to have some chronic GVH that they doctors are not worried about.
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