GVHD Already?

Chloe's bloody nose I left to help her with last night was followed by some more itchy palms and feet and just as we were getting settled again, another bloody nose. So we were up until 2 am and she is really tired and a little onery - though she won't admit it.

Today is the second day Chloe has had white blood cell counts of 100. I don't think it really means anything yet, although the Doctor thought they might be 0 today, so i guess that is a good sign. So it could mean that her donor stem cells are trying to engraft and are producing some white cells. One of the reasons we think this might be the case is that her mouth sores have gotten a little better - so maybe the few white cells she has are fighting off the sores. Full engraftment isn't until the white blood count stays above 500 for a few days which could still be a while. However, we're starting to wonder if the itchy palms and feet, bloody noses, vomiting, nausia, stomach pain and diarehha are actually symptoms of Graft vs. Host Disease (GVHD). GVHD is a side effect of bone marrow transplants and happens when the donor cells attack any remaining cells she might have in her body so they can take over. The symptoms she is having are often GVHD symptoms. You can read more about GVHD here.

The Doctor thought that is was a little early to be having GVHD as it usually happens when the white blood cells really start to rise. But, there are no other explanations as to why she is having all of these symptoms. A little bit of GVHD can be good as the donor cells kill of remaining host cells. So if there were any remaining Leukemic cells in her body(we pray there are not), a little GVHD can help kill them off. But, if the GVHD is not under control it can be life threatening. So it's kind of a double edged sword. Anyway, she continues to have those same symptoms today. They could get worse as the donor stem cells keep making their home in her bones and produce more cells.

Last week we were kind of excited for her because she had hair stubble all over her head. But this week it is all gone again. Delayed side effects of the chemo i guess. She had a couple of bad nose bleeds again this morning and had to get another platlette transfusion. We were thinking yesterday about all of the times she has been under anestesia for bone marrow samples or spinal taps, or all of the transfusions she has had. I don't have a number, but I think it is more than any kid should have. She said she likes the milk (anesthesia) the give her when she falls asleep though, it makes her feel silly. She was so tired this morning because of our late night last night that I made her take a nap. She wasn't pleased with me, but maybe she will thank me later. Probably not.