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Old Fri Jun 10, 2016, 07:02 PM
sandra4611 sandra4611 is offline
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Join Date: Feb 2015
Location: San Antonio, Texas
Posts: 1
Failed Transplant/Relapse of MDS

My husband is facing DLI for relapse/failure of transplant. He is at day+90. Chimerism was 88% at day 28, 93% at day 56, and his most recent test from day 80 is still 93%. His sister was a 10/10 match and although he was late to engraft (first signs at day +21) he has had no side effects from the transplant. Due to the reduced intensity conditioning (he is 68) he developed mucositis in the second week but it only lasted two days. Otherwise it's been smooth sailing...until six weeks ago. All his counts were in the low normal range and then his platelets dropped 20 points. The next week they were down another 20 points. Doc stopped Bactrim (Septra) antibiotic since that can affect platelet count. No change, kept falling. Doc reduced Tacrolimus, kept falling. Doc stopped Tacrolimus altogether. Another drop. Mike has gone from 149 to 43 in six weeks. Doc did a bone marrow biopsy. Blasts are 7% - same as before transplant. We don't know if it was 0% and then rose back to 7% or if it never went down at all. Hemoglobin has stayed at 13.8 -14.0 but just this week, his white count dropped down to 2.4 - a full point. Biopsy shows no Y chromosomes, which is good, and no new chromosome damage, also good. Doc says we can't really call it a complete failure because it did "fix" the red blood cells, his most affected cell line. But with mixed chimerism & blast count, it could be a relapse. Guess it doesn't matter. He's still got MDS and the doc says he is likely to develop AML soon. He is starting my husband on Vidaza for one month and then will add DLI for 5 days along with the second month of chemo. Mike was on Vidaza for 13 rounds before transplant and did fine. No side effects. The literature says DLI is not likely to work and his outlook is poor.
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