Has anyone had a transplant for AA and needed a "top up" known as DLI for mixed chim

[Bishbop]

Hi guys

My names Sarah I have VSAA, I had a failed round of hATG last year and a non related 10/10 matched donor stem cell transplant 12/12/14

I have had 3 bone marrow biopsies post transplant

The first showed that cellularity had increased to 20% and the chimarisam showed both CD15 (the Hb/ platlete / neutrophil making bit) and the CD3 (the lymphocyte, T-Cell making bit) where both up in the high 70s low 80s % donor (can't remember the exact numbers but good)!

My second showed that cellularity had increased to the full amount for my age at 70% and both CD3 and CD15 had grown to high 80something % donor

I have not got the official paper work back from my third yet so I am not sure if the cellularity has stayed the same or not but the CD15 (if that is the blood cell part) has grown to 97% which is fantastic the problem is with the CD3 the T-Cells have dropped right down to 45% which is way to low.

My platletes grew from pretty much day 1 and reached 177 at their peak 2 weeks ago, my neutrophils stopped needing GCFS to boost them around 5 weeks ago and have been sitting nicely at around 5.50 - 6.00 on their own each week whilst my Hb started to climb around 8 weeks ago reaching 115 the other day and becoming completly transfusion free for the last 8 weeks! So on paper it looked like everything was going amazingly well before the news of my third BMB (it maybe worth mentioning but not that significant that my Hb and platlete counts took a big hit the other day due to a nasty infection but have stabilised and have started to grow again of the own accord)

I will be having a meeting to find out more and the next steps in treatment tomorrow afternoon with my team but the doctor has all ready told me I will most probably have a DLI transplant or lynphocyte "top up" it's just a case of deciding when is best and if it needs to be done sooner rather than later. I must admit that I am I little concern as hearing you transplant is rejecting is the news I and I'm sure everyone else dreads to hear, I'm keeping all my fingers and toes crossed that this rejection can be rectified and doesn't lead to complete graft failure and a second transplant as I feel I've already dealt (as we all have) with so much.

I'm sorry that this message is so long I just wanted to get it all correct and ask anyone if they had had any kind of experience with DLI "top up" transplant especially with AA and what the procedure was/ how it was for you?

Thanks for your help guys xxx

[Jyefamily]

Hey! Just wanna see how you are doing now.
And was wondering if you have done a total body irradiation before ur transplant? Do u have problem with ur menstrocycle at all? WHat do u do to prevent bleeding? Thank you!