[evansmom]

Laura,

With your lower platelet count and the doctor weaning the immunosuppressant a bit on the early side, I wonder if he is seeing some red cell fragments (schistocytes, shredded red cells) on your smear. Cyclo and tacro can cause microangiopathy (injury to the endothelial lining of the microscopic blood vessels, esp. in the kidneys). This causes your body to send fibrin and platelets to these areas of injury. The platelet count drops and the fibrin threads criss-crossing the little blood vessels cause the red cells to tear in half as they travel through. This would also keep your red cell count down.

Ask him if he sees red cell fragments on the smear. Maybe it's more common than we think as Evan had this as does another post BMT boy we are both following right now.

Keep well,

Nicole