by Juraj Koska

Happy belated Easter to all! Thomas’ journey to complete healing continues. According to his last bone marrow biopsy on April 4th, 100% of all his blood cells and their bone marrow precursors are from the donor. A previous biopsy in March still showed a very small percentage of Thomas’ T-lymphocytes. Now, everything has been taken over by the donor’s cells and Thomas can literally feel it in his guts. Last month he started to feel more tired, his stomach was upset on most days, and he had very little appetite. These symptoms are typical for Graft-versus-host disease when the entirely new immune cells from another person invade and fight the host organism. It mostly affects the gut and skin, and in more severe cases can attack the lungs, liver, and kidneys.

Thanks be to God, Thomas’ symptoms are confined to his stomach, and they appeared to abate a little bit last week. Nevertheless, he still lost about 9 pounds over the last month. This worried his doctors, so they ordered gastroduodenoscopy (esophagus, stomach, and duodenum) and sigmoidoscopy (lower colon) tests last week in order to decide whether to start steroid therapy. The doctor noticed some mild redness/inflammation in the stomach mucosa, but his intestine was normal. The biopsy results won’t be available until later next week. If the inflammation is mild and Thomas is able to start regaining some weight, he may go through this without or on a minimum steroid dose. Though inconvenient, these symptoms are another sign that the transplant had worked, and it may even destroy any leukemia cells that had been left dormant. All laboratory tests are excellent, and if the next bone marrow biopsy on day 100 post-transplant (May 13th) continues to show good results, the doctors may start reducing the immunosuppressive therapy. Once off of it, he will be able to return to more activities.

Yesterday, his excitement about his plans of going back to school was boosted by a visit from his track and field and cross country coach from the University of Alabama. He drove all the way from Tucson where the team was attending a meet.