Day 15- Post transplant

OK, had meeting with Doctors, they said that yes he has Graft versus Host disease and the infection from his poo. For those that missed it yesterday, i will begin from the start.

Graft versus Host Disease.

Its a common complication of this type of Transplant. About half of the patients develop some degree of GVHD. Most of the cases are mild to moderate.

The T- Lymphocyte cells from the donor (Luke) may recognise the child (Brody) own body cells as foreign and try to destroy them. This happens because the child (Brody) own immune system has been suppressed or eliminated by the conditioning therapy before transplant. We also have to remember that before the conditioning therapy Brody had double chemo to reduce the cancer level on top of all this, so his immune system was totally eliminated.

Acute GVHD occurs in the first 100 days of Transplant and primarily affects the skin, liver and gastrointestinal tract (gut). GVHD may be mild, moderate, severe or life-threatening and may effect one organ or more at the same time.

GVHD is classified on a grade system 1-4, Grade 1 is mild and grade 4 is life threatening.
Symptoms of Acute GVHD are skin, itching, burning, redness of palms or soles, rash all over body, blistering.
Gut- nausea, vomiting, abdominal cramps, loss of appetite, offensive smelling, watery diarrhoea which may become bloody
LIver- jaundice, swelling, abnormal liver function tests.

Now Brody shows alot of these signs, except his liver has no effects at this time. He has shown these pretty much from just after the transplant happen. Because Brody has the infection in the poo, they don't know if the diarrhoea and smelling is from the GVHD or the infection. They need another day to let the meds work from yesterday to get a better picture.

Treating GVHD, the combination, dosage and duration of meds chosen to treat Brody will depend on the grade, and duration of acute GVHD. They have told me they will treat him with Steroids tomorrow. Which means Brody's GVHD is moderate to severe, but i have yet to confirm with doctors on how bad it really is. I did talk to the student doctor tonite and she said his skin was about a grade 3, but it depends on how he goes the next couple of days as it could get worse. So don't think the bad yet as we still have meds to help treat it.

The steroid work by suppressing the immune response of the donor cells (Luke) to the Brody's cells. If the GVHD does not respond to this there is another two drugs they can try.

Children who develop GVHD are again at higher risk of infections!!!!!!!
Hopefully tomorrow i will find out a bit more information as i have so many question. But poor Brody is not his happy self as much now. Thanks again everyone for all your support and hope everyone has a great nite at Tuncurry bowling club tomorrow night. Thanks xoxoxo