Day +27: no progress

Well, the higher dose of the prednisone doesn't seem to have done much good. Mina Brigitta's rash has gotten redder and has spread to cover almost her entire back and about half of her chest. It's also on her head, neck and face, and the palms of her hands are bright red. Dr. Cowan would say it was progressing or getting worse, only that it was "evolving". One thing we know for sure is it's not getting better. She continued to throw up today, and spiked another fever in the early evening.

Given all the symptoms, the doctors decided not to wait any longer to step up the treatment. They're switching her from cyclosporine to tacrolimus, a similar anti-rejection drug but one that is known to concentrate in the liver and gut, where Mina Brigitta is having symptoms. They're also treating her with Infliximab, a mononclonal antibody that targets T-cell lymphocytes. She'll get that once a week. Since all of the blood and urine cultures have come back negative, they're thinking the fevers are GVH-related, which makes sense to me. The hope is that the new treatments will begin to take effect over the next several days.

We needed a bit of good news today, and got it: the engraftment study came back, and it showed 100% donor cells! The test is only sensitive to about 1%, so there's still a chance that some of her own cells could grow back to measurable quantities at some point, but it's a good sign to be at 100% at this stage. So if we can just get through the couple of weeks, we have good reason to hope that the cancer will stay away.