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Transplants Bone marrow and stem cell transplantation

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  #1  
Old Mon Aug 4, 2014, 02:15 PM
pdiitdelhi0204 pdiitdelhi0204 is offline
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Location: New Delhi, India
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+33 days post MUD transplant(10/10)- WBC and Hb low

+33 days: Arnav (My 2 year old Son) doing well and skin biopsy confirms grade-I GVHD. They given some medicine for the GVHD. Other parameter are perfectly ok. Today count is:
WBC: 2800
Platelet: 79000
Hb: 11.5
Doctor said they are little worried about low WBC count and interested to see Chimerism result, which will be available tomorrow.
Arnav got platelet engraftment very early,i.e on day 12 and neutrophil engraftment on day 17.Platelet is in increasing mode since then, but WBC is now decreasing.
Hb was also constant near about 9 for some time, but suddenly Hb also dropped to 7.8, and Arnav got blood transfusion on day +29.
When Hb become in range and why this up and down in WBC count.Arnav already got 2 blood transfusions post transplant.Why Chimerism test is so important for Doctor now. Pray God Help my child, how much more waiting for good count.
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  #2  
Old Mon Aug 4, 2014, 05:06 PM
DanL DanL is offline
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I am sending prayers to your family that Arnav has a full recovery. Checking chimerism at 30 days seems a little early, but it may give the doctors an idea as to whether the graft is taking in light of falling blood counts. It seems that normal practice is to check at about 60 days, but a 30 day can give the doctor a starting point.

As for the blood counts and transfusion needs, I have seen people on the forums need blood transfusions as late as 6 months after transplant and still have a good recovery. The one thing that we know is that they will fluctuate, sometimes wildly. Initially your marrow is working very hard to make new blood, it reaches a certain level, then slows down production, and then may speed up again to get to the right amounts.

Since my transplant in February of this year, my wbc has gone from 1.5 when I was released from the hospital to 8.8, back down to 2.7 back up to 5.8, and this could reflect any number of causes, viral infection, marrow changes, or even GVHD according to the doctor.
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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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  #3  
Old Mon Aug 4, 2014, 07:30 PM
Whizbang Whizbang is offline
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30, 60 and 100 days is normal for post BMT/SCT...

Doctors want to monitor the chimerism, and treat as early as possible... They can alter the medications you are currently on to balance the chimerism and minimize the effects of GVHD...

As with counts, as Dan said, the three blood lines go through cycles (WBC, RBC and PLT's) each has a different life span, and they can swing wildly sometimes as your body struggles to keep up with demand... Especially when you have active demands, such as infections, or when some medications suppress a certain line of blood...

All the Best, and may God Bless us ALL!!!
David
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Married, father of three daughters; now 46; diagnosed w/ Major form MDS 6/18/2013; had low counts across the board; Multiple chromosome abnormalities; Finished 2nd round Dacogen 9/13; SCT - Oct. 31, 2013; Sibling match 10/10 ; 5.5% blasts down to 3%, now 1% (post BMT)
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Old Wed Aug 6, 2014, 08:35 AM
pdiitdelhi0204 pdiitdelhi0204 is offline
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+35 days post transplant-aplastic anema-Mixed Chimerism(81%donor and 19% recipient)

Dear All,
Today we received the Chimerism report of Arnav. Doctor said report is not good.Report says 81% donor and 19% recipient.They were expecting 100% donor.They reduced the cyclosporin dose to 50%.I dont't know what will happen because it will also increase chances of GVHD. Anybody experience of mixed Chimerism at 30 days.is it due to cyclosporine dose? or reduction of cyclosporine dose so early.
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  #5  
Old Wed Aug 6, 2014, 11:40 PM
Heather8773 Heather8773 is offline
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My husband has had a mixed chimerism almost his whole post transplant time. No GVHD but we are hoping lowering his meds will increase his donor cells
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Heather, wife of Ronald 36; dx PNH 2012; Dx VSAA 2013; eculizumab(Solaris) hATG 2/20/13 cyclosporine 400 mg daily. 37 units RBC and 15 units of platelets. Post BMT -pentam,vorconizole,valtrex, valcyte, actigall, Pepcid , prograf, magnesium.
10/10 MUD 10/10/13
Now no PNH or AA. Mixed Chimerisim
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