[evansmom]

Stephanie,

I am so sorry to hear about your son, a worrisome situation to say the least.

My son had a mismatched unrelated BMT in June 2008. The donor was a 9/10 with the mismatch on the alelle of DQB1. This is not an overly important area to match so if any of the available donors mismatch here, that may not be a big problem. A mismatch at A,B or C is much more serious.

Cord blood is more forgiving due to it's relative lack of exposure to viruses and therefore lack of antibodies. A perfect match is less important here, and may very well be the best choice at this point.

Did your son have a full myeloablative transplant or a reduced intensity transplant? At this point, if his health can tolerate it, he likely needs all the big guns to completely wipe out his immune system and maybe higher blood levels of cyclosporin post transplant to keep him at 100% donor.

Without an ANC, and being post BMT, he is so very susceptible to infections, particularily of a fungal nature. Keep him far away from any potential sources...mold, mildew, bird droppings, non-domestic animals of any kind, schools, barns, old buildings and the list goes on. I'd be putting an N95 mask on his little face anytime I had to take him somewhere questionable. It may not fit him entirely correctly, thereby reducing its effectiveness but at least it's better than nothing.

Time is of the essence. Would a prophylactic antifungal med be appropriate here?

Best wishes, stay strong.