Day +159

My Blood Count Today:
Red Blood Count (RBC) = 117(Normal 130-180)
Platelet = 113(Normal 150-450)
White Blood Count (WBC) = 2.8(Normal 4 - 11)
Absolute Neutrophil Count (ANC) = 1.344 (Normal 1.5 - 8.0)
Potassium = 4.5(Normal 3.5 - 5.2)
Blood Pressure = 160/100 (Normal 120/80)

I went to UH to do my follow-up today. All blood counts dropped. The most notable one is the white blood count which dropped from 3.7 to 2.8. In other words, it dropped 23.4% :-( With ANC lower than 1.5, I am considered having neutropenia now, which means that the body resistance to infection is low. I believe I need to isolate myself (闭关练功) again :-( Furthermore, the blood pressure is also high, so doctor advised me to take Norvasc again :-(

One good news is that the cytogenetic result for bone marrow sample taken on Day +80 shows that my pair 23 chromosome remains to be XX. That means my sister’s stem cells engraved well and are producing blood.

The doctor wanted to cut down the anti-GVHD drug (Ciclosporin) as soon as possible because there is no sign of GVHD. This drug is immunosuppressive agent which suppresses one's immune system. By reducing the dosage, the immune system will not be suppressed too much so that it would attack Leukaemic cells in the body, if any left. It is just like we brought home a fierce dog (new immune system). Initially, we have to chained it because we worried it would attack someone (host organs) at home. Now the dog is a little bit tamer, we loosen it so that it would attack the thieves (Laukaemic cells). This effect is called Graft-Versus-Leukaemia.

Patients who are unfit for full transplant due to certain circumstances such as weak organs will be given mini transplant. The chemotherapy intensity before the infusion of stem cells is reduced for this type of transplant, and thus there might be more Leukaemic cells left in the body compared to full transplant. In spite of this, the mini transplant can be effective because the body relies on Graft-Versus-Leukaemia to terminate the remaining Leukaemic cells in the body.

See you next post :-)