@janetlen Generally, the first 2-3 weeks after transplant are the most note-worthy. Starting a few days after the infusion the side effects from the preconditioning chemo become noticeable with increasing fatigue, possible nausea/digestive tract issues, possible mouth sores and hair loss starts around day 10. Sounds delightful, huh. Hang on, it’s temporary. 😉Once those new cells engraft, they begin to set up housekeeping. The first sign of neutrophils can bring relief to the worst of the symptoms. Slowly but steadily things improve with lessening fatigue, more stamina. But you can’t rush any of this. Listen to your body and rest, rest, rest!

As the title of your discussion suggests, the first 100 days of a new BMT patient are the most critical. Because the newly implanted stem cells are developing into your new immune system, there is a huge amount of adaptation required by those new cells. The new immune system is aggressive and referred to as the graft. Your body, the host, is just the vessel for these new cells and is a foreign environment. As any good immune system should, it will seek out potentially harmful entities and launch an attack. Well, unfortunately that would be your body! Graft vs host disease, which can be a big problem if not caught early in those first 100 days. After that time, anything that pops up is usually not an acute situation and comes on gradually.

So initially the new immune system has to be held back a little. That’s where meds such as tacrolimus come into play. It’s a strong anti-inflammatory drug that acts as an anti-rejection med, basically restraining the immune system until it can learn to adapt to the newly discovered proteins in your body. Over time, usually about 3+ months or so, it tends to simmer down. Hence the 100 days… About that time, your doctor will start the taper off the Tacro. It can take some people longer than others. I was on tacro for 2.5 years before those overly zealous cells decided to play well together with my body! LOL. But that was no biggie. I felt fabulous, healthy and no AML!
So for now, eat as healthy as you can, drink plenty of water and try to walk around as much as you’re able. I know you’re not one to sit idle and you’re very disciplined…I’m the same! So don’t be discouraged if you feel like doing nothing more than sleep the next couple of weeks. It’s not a sign of weakness…it can’t be helped! You’ll be up and active again in no time, with a 2nd chance at a new life. ☺️

@janetlen
Hi Janet, just checking in to see how you’re coming along. You’re at Day +7 and usually the next week or two extreme fatigue will be your companion. Hang in there, my friend. It gets better. Sending a gentle hug.