Days 10-13: Update and Good News

This morning, we saw Idan shed his first hairs, a painful reminder of what he has been through in the past few weeks.  But as we say goodbye to Idan’s beautiful hair, we say hello to his new immune system.  Today, we dare to hope.

It’s been almost two weeks since the donor’s cells were infused into Idan’s bloodstream.  Now, we are seeing small signs that they may have made a home in his bone marrow.

There are a few levels that are being monitored on a daily basis to determine the success of the transplant.  The first and only one we need concern ourselves with for the next few months is his neutrophil count.  This is the first type of cell to grow from the donor’s stem cells. Yesterday, after being at 0 for the last two weeks, Idan had 50 neutrophils.  The doctors believe this is an early sign of engraftment – i.e., success – because it is around the time when we’d expect the donor’s cells (now Idan’s cells) to create neutrophils.  We won’t know for sure until Day 28 whether these cells are the donor’s cells growing, or Idan’s own immune system coming back, but given the time frame, the doctors are optimistic – and so are we!  The counts will bounce around a bit over the next few days (and may even go down as neutrophils commonly do), but once they exceed 500 and stay above 500 for at least two days, we will know Idan has engrafted and we will be discharged from the hospital.

Assuming this is indeed a new immune system, the next hurdle we have to be prepared for is graft versus host disease.  It can be acute or it can be chronic, and the levels of severity differ greatly from patient to patient.  We hope that in choosing Seattle, in choosing the treosulfan chemotherapy and an institution with the highest survival rate and excellent treatment of GvH, this will be a minor obstacle at worst.

As for the rotavirus, Idan remains asymptomatic, which means it has not affected him in the slightest – Idan is his usual cheerful and energetic self.  We are still in isolation because it can be contagious and everyone on this floor has a compromised immune system.  The rotavirus will still show up in his labs until he has a fully functioning immune system, so we may be discharged long before we’d be allowed out of isolation.

Thank you all for your continued prayers and support!  Many of you have sent gifts and toys to entertain Idan and they are tremendously appreciated.  We feel blessed to have gone into this transplant healthy and strong, and we owe Idan’s good health all to you.

All our love,

Amanda, Akiva & Idani