2nd Transplant for MDS

[Amyleighd]

My dad had his 2nd transplant on Tues 4/5/2016 after the first one was determined a failure. He has been in the hospital since with a fever that no one seems to be able to figure out what is causing it. Has anyone experienced this after getting a transplant?

[italianburrito]

Yes my dad had a fever after his haploid transplant! His was due to the HHv6 virus which he received an anti-viral (foscarnet). He is doing much better now. Check to see if they have drawn levels for this virus and CMV.

[Amyleighd]

So glad to hear you father is doing better. My dad has been checked and checked for viruses and infections but nothing is showing. His fever has been down for the past few days and he was finally released from the hospital today to go back to the bone marrow clinic for his daily treatments. During his 1st transplant he did get that same virus as your dad and was on foscarnate also......that is a harsh med!! The BM doctor thinks the fever may have just been from the amount of cells they give him on the 2nd transplant or possibly a reaction to the radiation. Today is day +9 on 2nd transplant so I'm praying hard this one works!

[DanL]

Amy,

I did not see any blood counts posted for your father, but one thing that is a documented phenomenon in MDS patients is neutropenic fever. It is a fever of otherwise unknown origin that seems to be tied to a lower number of neutrophils. this usually goes away when the patient produces and keeps more neutrophils. During transplant, it seems like you hit the low spot around day 6-13 and then start recovery sometime thereafter, usually by about day 20. Not sure if this is the case, but it might provide some explanation.

[italianburrito]

Any updates on your dad??

[Amyleighd]

Update: Today is day +30 for the 2nd transplant and things are going better this time around so far. The fever he had in the beginning they seem to think was from the increased radiation. (It was increased by 50% from the 1st transplant). Today his white count was up to 5.2 (highest its been since Dec). Yesterday they stopped the Granix shots in order for the bone marrow to start producing red cells and platelets so we hope to see those come in soon. Today however, we did get the news that he has that HVV6 virus again and will go back on the Foscarnate for 10-14 days. He has not had much of an appetite, which seems to be pretty common. Getting him to eat can be a challenge! He also has some shortness of breath and is retaining some fluid and the Foscarnate will only make that worse. So currently we have a balancing act going on with the meds!! Once he makes it to day 35 with no GVHD they will stop the mycophenalate and that will help his immune system begin to fight off viruses on its own. Thank you all so much for the input and support on this forum.

[Amyleighd]

Bad news today.....My dad has been admitted to ICU at Duke. He has developed pneumonia and a bacteria infection in his blood. His white count is trying really hard to fight but the new baby cells are just not strong enough. Praying hard that he can pull through this!

[Neil Cuadra]

Amy,

This is worrisome news. Post-transplant infections are one of the biggest challenges for a new immune system. Let's hope that he and the medicine have the strength needed to fight through this.

[PaulS]

Hi Amy - shortly after my transplant I had a similar infection - and was sent to the ICU for a couple of days - very scary place to be sure. I also had fever - they put me on an oxygen mask that forced air into my lungs - just short of a ventilator, which they considered. Fortunately - the infection responded well to the antibiotics and I emerged battered but not broken - hopefully your Dad will also respond to the antibiotics and this will be just another scary bump in the road. Hang in there.
paul

[Amyleighd]

Thank you Paul and Neil, that makes me feel a lot better. He is on oxygen and they were considering a ventilator also, but for now have decided his oxygen level is holding ok with the mask. The problem at this point is the infection(s) he has are what is called gram negative and can be antibiotic resistant and hard to treat. Hopefully this is just going to be a bump in the road and things will improve in the days to come.