[Ruth Cuadra]

Hi, Nicole.

I'd say it's pretty remarkable to be down to 7.5mg/day of prednisone at 8-9 months after transplant. It took me more than a year to get down to about 10mg/day. I've never been able to get below 10mg/day because I have an adrenal insufficiency that pre-dates my aplastic anemia/MDS diagnosis. On top of that, a lower dose causes a flare of GVH symptoms, particularly in my mouth. I understand from my endocrinologist that 5mg-10mg/day is a basic replacement dose for what the body normally produces. I've been taking that much for most of my life with no ill effects on bone density or any of the other concerns usually expressed by transplant doctors and stated as reasons that patients should be tapered off as soon as possible.

Given that your husband is still feeling poorly after so many months, it may be worth giving the slightly higher dose of prednisone a try. The chances of incurring any long-term damage from a few months on 10mg are slim while the benefits to his overall well-being and recovery could be great. If and when he is able to taper off, it should be done very slowly--at the rate of 1mg per month or less.

Hope this helps.

Regards,
Ruth