transplant and hello

[tserdogan]

My name is Serkan.34 years old male.Today is 33. day after transplant.My counts good(WBC:2,9-PLT:82-hgb:9,6) but i have another problem may be you also had this problem.Nearly one month i have got cough problem and serious,controls have done,also no problem but i have got 24 hour cough.because of this i can not go to home.

[Birgitta-A]

Hi Serkan
Congratulation to the good SCT results! Can the cough depend on GVHD and be treated with drugs for GVHD like Prednisone?
Kind regards
Birgitta-A

[Ruth Cuadra]

Hello, Serkan.

Welcome to Marrowforums. You seem to have recovered your blood counts very quickly after your stem cell transplant!

It could be that your cough is a side effect of one or more of the medicines you are taking. The problem could be related to the use of immunosuppressive drugs like Cellcept (mycophenolate mofetil) or Sirolimus. I think you should ask your doctor about the possibility that your medicines are contributing to the problem.

Here are some references for your doctor on this topic. Unfortunately, the abstracts do not seem to be available online.

Mycophenolate mofetil and cough.
Elli A, Aroldi A, Montagnino G, Tarantino A, Ponticelli C.
Transplantation. 1998 Aug 15;66(3):40

Mycophenolate mofetil and cough in pediatric patients.
Fijo J, MartÃ*n Govantes J.
Nefrologia. 2000 May-Jun;20(3):297-8. Spanish.

Irritant cough and sub-febrile temperature under immunosuppression
Saner E, Vogt B, Mohaupt MG.
Praxis (Bern 1994). 2004 Feb 4;93(6):197-9.

Regards,
Ruth Cuadra

[tserdogan]

Hi Ruth and Brigitta,
good news Im going to out hospital today with my cough,
Ruth doctor said to me your opinion because check with torax is clear,maybe its allergic.

I'll give you details later,

god bless us.

[Ruth Cuadra]

Serkan, I am glad you are leaving the hospital even with your cough. Please take care of yourself and let us know how you are doing when you can.

Regards,
Ruth

[tserdogan]

Hi again,
i didn't sleep well yesterday but being out of hospital is good.I did not eat anything at hospital one month from the bmt.I eat from three days,it is hard to start eating,drinking and getting pills.do you have advices for this

[tserdogan]

Hi,
My coughs are nearly stopped.
I walk around my apartment every morning.My body balance is increasing slowly.
These days my counts are decreased to(wbc:1,8-plt:75-hmg:8,5).My doctor said to me;some of medicines decreased the blood making.For example:Valtrex and Tavanin i used to,we cut it off.Now we are waiting wednesday.We will check blood counts.I hope it will increase again.

[Ruth Cuadra]

Hi, Serkan.

How are you doing? I remember it was hard to eat after my transplant because nothing tasted very good. I didn't have much appetite but I liked things that were cold. I wasn't allowed to eat any fresh fruits or vegetables that couldn't be peeled. It was such a treat to have a salad on Day +100.

Regards,
Ruth

[tserdogan]

Hi Ruth,
Day 48 and my counts are like this.A little bit increasing wbc:2,0(1,8)-PLT:94(75)-HMG:8.0(8,5). I was VSAA till February 2009 and these counts are fantastic for me.
My blood is not increasing now and transfusion at week.
%98 donor cell.The doctor said to me we will check it every 20 day.
CMV is negative and we check it every week.
I think my counts are slowly increasing and may be this is more safe for me.

[Ruth Cuadra]

Hi, Serkan.

98% donor cells is excellent! I remember it took months for my platelets to get above 50, which was considered necessary for safety, so your 94 is amazing to me.

Regards,
Ruth

[tserdogan]

Hi Ruth,
I read your story when i was in day 0,and i felt very good.I look future optimistic.Also now when i ask you a question,you help us.Thank you for everything.

[tserdogan]

Hi,
After transplant day 60 and i still take red blood once a week,do you know when will i be red blood transfusion free?

[tserdogan]

Hi,

Day 79 and counts are like this.

Plt:118 raising
Hct:22,7 decreasing (i got one pocket blood at nearly ten days)
Hgb:7,2 decreasing
Wbc:6,0 raising
Neut:5,0 raising
Cmv:Negative

Biochemical is not perfect.Kreatin ad serum is fine.Bilrubin(1,83) and Alt(96) is a little bit high.

[Ruth Cuadra]

Hi, Serkan.

Even though your hemoglobin still on the low side, your other counts look good. How are you feeling? That's at least as important as how high your hemoglobin because everyone is different. It's not unusual to still have red blood transfusions for months after transplant. Since you are still less than 100 days out and have lots of platelets and white cells, I would say you are doing very well

Regards,
Ruth

[tserdogan]

Hi Ruth,

For example i took red blood today again.My donor blood A+,mine is 0+.Still i took 0+ red blood.My last donor cell ratio was 99 percent.Doctor says to me it will be nearly 90-120 days to change your blood type.i hope today was my last red bood transfusion
ı feel good when hemo is higher than 7,5.But standart range is 13-14.

My whites are decrease to 4 today but i know it can be...

Bye,

[Vera W]

Hi Serkan, thank you for writing me, all of this stuff just takes time. You have to take it a day at a time. My muscles are so shaky from the drugs that i fell on my deck when my legs buckled. I still have alot of fatigue but i keep moving. Hang in there Vera

[tserdogan]

Hi Vera,

Next tuesday is my 100 day bmb day.Till 15 day my plt decreased to 118.000-70.000.I will see what is going on my marrow.İ hope everything going well all for us.

Bye,

[tserdogan]

Hello again,

Things are interesting.Bmb checked and bone marrow working enough.Although my donor cell is %99 but counts are decreasing again.Plt decrease to 58,Wbc decrease to:1,9,Neut decrease to:1,2.Red blood transfusion still.Also still my blood type has not changed to donor.
No GVH and cmv.
Daily cellcept:2000 mg
Daily Sandumin Neoral:150 mg
Prednol:4 mg every other day

is there any ideas why my counts are not increasing.

[squirrellypoo]

I don't know about the counts, but if it makes you feel any better, my blood type is still my original one, too. (I'm at Day 115 today)

[Laura]

I have been having the same issues with counts dropping, increasing, dropping, plateauing, etc...my doctor says that they see this in people who have had transplant. This past Friday however my counts finally increased somewhat!!!! Just have faith...they will increase!!!

Laura

[Laura]

Side note:

I was also 95 percent donor in BM and 100 percent in the blood. But only 5 percent cellular. My doctor did a "fast" taper of the Prograf to try and get the counts to come back up. (My counts initially dropped pretty low...needed Neupogen.) It has been a very slow waiting game...waiting for them to increase.

Laura

[tserdogan]

Hi,

Thank you for replying Squirrellypoo and Laura.
My doctor changed my med dosages.
Prednol dose raised to 48 mg.
Cellcept dose decrease to 1000 mg
Sandumin Neoral same 150 mg.

We will see tuesday.What will change about counts.

Serkan,

[Laura]

I am not trying to be a downer...but when we tried dropping my Prograf, we did not see much of a change in my counts for a very long time (in my opinion). So try not to be too disappointed if there isn't a real change this next set of labs. I am really hoping they are higher though!!!

Laura

[tserdogan]

Hi Laura,

I think prednol works.My doctor thought that GVH decrease your counts and he raises to sandumin 150 to 250.Prednol dose decrease 48 to 32. Today counts Plt increase 58 to 61,Wbc raise1,9 to:4,2,Neut raise to 1,2 to 3,5.Next lab is saturday.

Serkan,

[Vera W]

Good Going!!