[Ruth Cuadra]

Hi, Lynn.

As you know prednisone is an integral part of ATG/ALG treatment and, since everyone responds differently, there cannot be a set length of time for being on it. A dose of 200mg/day isn't unusual at the start of treatment, but it's usually stepped down within a week or two to something much less. With your history of serum sickness, your doctor may well want to keep your prednisone level up until you've passed the point that it might happen again.

When I came home from the hospital after my transplant, I was still on about 50mg/day. Although we were able to taper down from there to about 20mg/day in a few months, it took a couple of years before I could get off it entirely. One reduction might cause an increase in my mouth GVHD symptoms, so we'd increase it again and wait. It's easy to get frustrated with such a slow taper, but it is important to go slowly to prevent flareups and relapses.

If you end up with severe reactions like the shakes and disorientation this time, be sure to let your doctor know. It could be a combination of medications that cause those kinds of symptoms and not just the prednisone itself.

Hope this helps.
Ruth