White patches inside mouth(Day 119)
 

Dear all,

Hope all of you are fine. I am Dhruba from Dhaka, Bangladesh. My wife diagnosed with Severe Aplastic Anemia and had an Allogenic Stem Cell Transplantation on March 16, 2011 in Christian Medical College Hospital, Vellore, India (www.cmcvellore.ac.in). Her current counts are listed below:
Hb=8.9
TC=5600
Neutrophil=61%
Platelet=75000
Creatinine= 1.1

She is now taking 50 mg Ciclosphorine daily.
She had no GVHD. But 4 days ago I saw some white patches inside her mouth. So, today I meet with our consultant in Dhaka, Bangladesh and he told us that it is some kind of mouth GVHD. But he ensure that it is very mild and nothing to be worried. Actually no Bangladeshi doctor has the experience of BMT/SCT as this facility is not available here.
So I want to know it from you. I also want to know what life style, food etc will helpful for her early recovery.
I am eagerly waiting for your valuable suggestion on this regard.

Thanking you
Dhruba
+8801199884717

Dhruba,

Your wife's counts are very impressive at Day 119! It was many, many months for me before my platelets got to 50,000.

Regarding the white patches in your wife's mouth, these are almost certainly GVHD. It is important to understand that GVHD can appear at any time following transplant. When it occurs in the first three months after transplant, it is called "acute" and thereafter it is called "chronic," regardless of how severe it might be. Since it is already more than 100 days since your wife's transplant, the white patches you see in her mouth are likely to be chronic GVHD. I had these patches in my mouth for a long time after my transplant. Ask the doctor about an oral rinse to control the spread and irritation that these patches may cause. And watch carefully for other signs of GVHD, particularly in the form of rashes on your wife's skin. She is taking a relatively small dose of cyclosporine at this point so if new symptoms occur it might be necessary to increase her dosage temporarily.

Regards,
Ruth

Thank you very much. Be happy...