[DanL]

Shikha,

I thought that I had responded to this post, but am sorry that I don't see it here. I am sorry to hear of your mother's troubles thus far, but believe that you can still hold hope.

Low blood counts after transplant can be attributed to several factors including relapse and a graft that doesn't take (worst case scenarios) or issues with too much immune suppression or underlying illness, like CMV or some other illness that brings down platelets and RBC.

Looking at your mother's drug list - there are sometimes reports of lower blood counts from taking bactrim and pentids. I happened to respond this way to bactrim, so my doctor had me do pentamidine treatments to try and stave off pneumonia. For the pentids, I don't know what would be used to replace it, but would ask if it is absolutely necessary as a prophylactic against bacterial infections. There are several other antibiotics that may be less harmful to blood production for your mother.

The other drug that might be causing lower blood counts is cyclosporine. It is a common immune suppressive drug to use after transplant, but each patient responds differently. A couple of possible replacements include tacrolimus and sirolimus, or MMF, or any number of other drugs. In many cases, reducing immune suppression or changing the drug used to suppress the immune system may help the graft become stronger and help blood production.

In my case, I was almost 2 years post transplant before my blood counts looked normal. I was still a little low, but not so low that I needed treatment or transfusions, so it may just be a matter of time.

Ask the doctors lots of questions and ask about alternatives.

I wish you and your mother best of luck in her recovery.

Dan