We jus finished meeting with the GvH team. Trish is officially having GvH. Her skin is red, pretty much everywhere, but her scalp. She is itchy much of the day and it is worse at night. They also gave her some fluids today, because she was slightly dehydrated. She never drinks enough.
Some good news. The RFLP (no clue what that stands for) results are in and she is showing 100% of the donor cells in her blood. She is officially part fireman.
So some GvH is good because it helps fight the disease, but full blown GvH is bad. They did a skin biopsy today to study the rash in her skin. We'll have those results on Monday and see how she looks and feels and on Monday, they will decide whether to treat her for GvH or continue to wait and see. All treatment for GvH involves high dose steroids over about 12 weeks.
They start high and ween her off the steroids over several weeks. GvH has about a 50% chance of coming back after the steroids. There is a clinical trial underway that uses one of 4 second drugs with the steroids in an effort to reduce the likelihood of GvH coming back. Trish being the good trooper that she is will likely choose to participate in the trial.
Another key indicator is liver function and kidneys. All of her counts on these are looking good. One other thing we learned today. Just because her white and neutrophil counts are good, doesn't mean she has a functioning immune system. You see the white and neutrophil cells are pre-occupied attacking her cells and though plentiful, don't act as a very good immune system against infection. The steroids help stop the immune system from attacking the host and help reteach them to focus on the real enemies of the body.
Monday we'll know whether she will bein treatment or stay in a wait and see mode. Things were going so well we thought we might get home early, but after today's visit with the GvH team it seems like we will be here for the long haul.
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