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DiscussionMy Bone Marrow Transplant (BMT/SCT) story: Will you share yours?
Bone Marrow Transplant (BMT) & CAR-T Cell Therapy | Last Active: 3 hours ago | Replies (578)Comment receiving replies
Replies to "I think one of the hardest things to understand (for me too) is the graft vs...."
@edb1123 While GvHD can be a bane to our existence, it is also an integral part of why we received the SCT in the first place. We need that internal battle brought on by the new immune system to attack the cancer that our old system could no longer recognize and control. Look at it more like, Graft vs Leukemia. Or Graft vs Tumor. Unfortunately in the early stages of our transplant the new immune system doesn’t differentiate. It looks at our entire body as an invader needing to be eradicated. That’s why initially we’re on the higher doses of immunosuppressants/anti rejection drugs. They act as an anti inflammatory drug to keep things calm. You’ve heard of the cytokine storm brought on by Covid 19? It’s the same thing when our bodies initially go into hyper drive with the new immune system. That’s why it’s imperative to keep our new immune cells quiet but working that first 100 days. We want them to work but not too aggressively.
My husband always teases me that it’s like a new guard dog sitting in front of me, just waiting for me to make a false move. As time goes one, at some point it will no longer see me as a threat and we’ll live an amicable life together. LOL.
My SCT was the end of June 2019. Until Oct that year I showed no sign of GvHD at all. I had one glimmer that the new system was working in August when CMV, a virus that was brought in with my new cells started showing up on blood tests. My doctor held off on giving me a stronger anti viral and just waited. By the next week, my new system had recognized its old foe and took it out! So that was pretty cool to know it was working.
I was feeling pretty cocky about not having any other issues until we began to realize that there was a bit of concern surrounding this. Was my immune system up and ready to fight for me in the event of a return of the AML? If it’s not reacting to any other stimuli would it be ready for invaders? Later in October my doctor started my taper off Tacrolimus and within 2 weeks I did start to have some issues with my hands and wrists. We were all honestly a bit relieved that there was some indication of activity. Though later on, the next GvHD battle was one of “be careful what you ask for” as my transplant doctor said when tackling this new round. But that was a year ago, it was handled and now I’m in a very steady period. I feel 100% normal!
After the first 100 days, we reach a period where any GvH that comes about is generally no longer considered Acute. Acute GvH can develop quickly and get out of control. Later in our transplants, most anything that happens comes on gradually and sometimes subtlety. That’s why it remains important to report in to your team any time something new creeps into the picture. Keep a little journal of new symptoms which arise. Sometimes a watch and wait then report... But we can’t live in fear of this as it is generally corrected quickly with steroids or other immunosuppressants to get life back under control.
We need to keep a sense of humor, sense of adventure and above all, a positive attitude.
I’m glad you brought this up! I hope others will chime in so we can keep this discussion going.