Chimerism
7/11/2022
Ian’s latest and greatest symptom was an itchy rash on his upper body - diagnosed as Graft-Versus-Host Disease. GVHD occurs when the donor’s cells (the graft) view the patient’s cells (the host) as foreign, and attack them. Ian’s case is considered acute, moderate and limited to the skin. A majority of patients get acute-GVHD (so it’s not surprising) and it’s generally treatable (so not particularly concerning).
Treatment for the rash was a steroid ointment that had to be slathered on three times a day, along with a menthol lotion, plus a dose of Benadryl and Pepcid. I imaged that Ian felt like a sleepy greased pig covered in bugs (but he smelled much better!). After a few days, the rash receded - without having to resort to oral steroids – although the itchiness lingers. Other lingering symptoms include fatigue, insomnia, taste and poor appetite – all of which are common and should improve over time. Even so, we are counting our blessings, because we know that his condition could be much worse!
A big milestone this week was Ian’s chimerism test, which measured the success of the cell engraftment by evaluating the mixture of DNA in Ian’s blood (Ian’s leukemia cells vs Donor’s healthy cells). The test showed > 98% donor cells, with zero of Ian’s cells detected! The transplant worked!!! More good news is that Ian’s blood counts are holding steady (no more transfusions) and his labs are looking extraordinarily good for this stage in the game (7/1 was Day +36).
While this was huge cause for celebration, there isn’t much partying to be had in our apartment, so Ian gave me a hall pass and I headed back to Greenville for the long July 4th weekend. While Ian is not supposed to be left alone, we both felt that he was stable and could manage for a few days. Fellow transplant friends drove him to the clinic and another transplant pair was right upstairs, if needed. Thankfully, there were no emergencies!
During my trip home, I got to see my BOYS, both my Dad and my Mom (who were switching out that weekend), and all of my friends. Being July 4th and the last week of swim-team, it was the very best time to be back in the hood! I was also glad that my folks got to experience the magic of Gower Power! On the fourth, we walked in the annual neighborhood parade, swam at the pool, and then set off fireworks – like big ones, in front of our house! Otherwise, my time was filled with swim team events – a meet, after-party, luau, tie-dye, shaving cream, slip n’ slide, and of course, TP’ing. I left Greenville completely exhausted and ready to finish out the summer in Durham!
