New Life, New Life

Found in our garden, March 27.  
Spring doesn't always happen when you want it to.  But it does always happen.

According to Dr. Beatty, Roger has “classic chronic GVH skin.”

Graft vs. Host Disease (GVHD) is a frequent complication of allogeneic bone marrow transplant in which the engrafted donor cells attacks the patient's organs and tissue. The acute disease occurs within the first 100 days after transplant, attacks many different organs and is more dangerous.

Chronic GVHD develops after the third month post-transplant. The chronic version is not caused by the donor’s cells attacking the host's body but by new T-cells produced after the donor's bone marrow has engrafted. Chronic GVHD manifests itself as skin problems including a dry rash, a change in skin color, and tightening of the skin. Hair thinning or uneven hair color may also occur.

Because GVHD in any form can be life-threatening if not kept in check, it’s important that it be monitored and treated by a doctor experienced with bone marrow transplants.  Roger will be on immunosuppressant drugs for at least a year, and may be treated with steroids if his symptoms worsen.  This summer he won’t be allowed to garden, mow the lawn, swim or even sit on the grass in the park.  There won’t be any warm potato salad at our 4^th of July picnic.  He will have to be cautious about contact with other people for awhile because the immunosuppressant drugs won’t allow him to fight off any contaminants that he might pick up. 

He’ll have to be extremely careful about exposure to sunlight for the rest of his life, as UV rays spark the development of GVHD.

This sounds like bad news, but it’s not.  Research shows that transplant patients who have a light case of GVHD have a better overall survival rate.  Those very same T-cells that are causing skin problems are also creating a “graft-versus-leukemia” effect.  That means, if any leukemia cells survived in the dark recesses of Roger’s bones after the chemo blitzkrieg and bone marrow transplant, the new T-cells will wipe them out.  Chemo was the air strike; T-cells are boots on the ground.

Just think of it:  A leukemia-free life.

Those T-cells are aggressive little buggers.  Buy stock in sunscreen.  Roger’s going to be around a long time.