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Transplants Bone marrow and stem cell transplantation

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Old Wed Nov 23, 2011, 03:07 PM
tarsus tarsus is offline
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Sudden platelets drop

Hi all.

After BMT from unrelated donor, I'm at day 55 now. My counts were ok pretty much since the transplant. wbc 4.5, neutrophil: 2 to 4, always above 2. PLT: after first week at home was just over 200.

Since then my PLT was dropping about 10/week. Last week it was 168 - which wasn't too bad.

Today they did the test and plt went down to 87. Repeated the test within next two hours - plt came up as 101. Neutrophil 3.6, wbc 4.9 hemoglobin 10.5 - as usual.

Obviously I'm freaking out. I've relapsed over 6mths ago after 2.5years remission from successful transplant from family donor, (same disease - new marrow too similar) but Fludarabine based conditioning put me to remission straight away (unlike previous time).

When relapsed, my neutrophil gradually started going down, from usual 2 down to 1.2 within a month, and platelets from just over 200(usual) down to 150...

So now I'm wondering... can I be relapsing, the same disease just completely different way? (starting from platelets, then neutrophils later? - opposite than last time), and such a drop of platelets within a week, without any significant white/red cell drop?

Is that possible? 2 weeks ago I had chimerism results: 100%.

I'm not very good optimist, nor pessimist - just relying on facts really... Doctors obviously said: Not to worry, just only one stat drops, and platelets at that - we're not concerned yet. Come back next week, if it's still down we'll do bone marrow, then we'll see.

I know it's the only way to be sure, but this week I'm gonna die of anxiety itself...

If someone had similar situation please, share or try to advise me a bit...
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Old Wed Nov 23, 2011, 06:00 PM
DanL DanL is offline
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Tarsus,

It seems that a lot of BMT patients have a drop in some blood line or another, but most seem to experience it around day 100. Is it possible that GVHD might be setting in and reducing the numbers?
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MDS RCMD w/grade 2-3 fibrosis. Allo-MUD Feb 26, 2014. Relapsed August 2014. Free and clear of MDS since November 2014 after treatment with Vidaza and Rituxan. Experiencing autoimmune attack on CNS thought to be GVHD, some gut, skin and ocular cGVHD. Neuropathy over 80% of body.
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Old Wed Nov 23, 2011, 07:19 PM
Neil Cuadra Neil Cuadra is offline
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Tarsus,

My wife's counts dropped at Day +70. Her platelets went from 44 to 19 and WBC and HGB dropped as well. But in the following weeks they all recovered and continued to improve.

We never knew the cause of the setback and we've since heard from others who had similar drops.
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