5/16/18 BMT Day +14 GVL vs GVHD

Reese couldn’t be happier to be “home” in the BMT. She has been sprawled out in the bed flashing smiles, reveling in her new bone marrow. She is on the mend, and while she has a way to go to fully recover from VOD, she is on her way!
Next on our mind: Graft-vs-Leukemia (GVL). We know that the only cure for JMML is a bone marrow transplant. And unlike some other cancers, there isn’t a second option. So we must cure the JMML, now. We also know that JMML is persistent- this is one of the things that makes it such a horrible disease. This is also why we are in San Francisco, at UCSF. This is where the doctors are who cure JMML, this is their life work, and they are the best at this. Reese is where she belongs to get well (and if where she belonged was on the moon, believe me, we would be wearing space suits right now curing my little girl.) Now, how do our doctors increase our odds of beating JMML? One way is graft-vs-leukemia. This is when the graft (donor) T cells eliminate any remaining leukemia that may still be lurking. We want graft-vs-leukemia… we DON’T want severe graft-versus-host-disease (GVHD). They are different. Now, managing that is what our doctors do, this is not easy, and this is why we need the best. Their goal is to reduce the risk of GVHD while maintaining or enhancing GVL. So we are praying for strong GVL to kill any remaining cancer cells, and I will keep you updated as we start to see signs of this, hopefully soon!
Reese’s counts are coming in early, but at a GREAT pace!! If cells come in too slowly, they need to boost them with a drug to wake them up. If cells come in too fast, it means they didn’t spend enough time picking a just-right-cozy spot and there is some chaos. But cells that come in at just the right speed mean we have a GREAT DONOR MATCH!! Stem cells can learn, and they are learning to recognize Reese’s body as their own. And they are alike enough (12/12!!) that this has been smooth sailing! We thank god, our doctors, the nurses, Be-the-Match, and our most giving DONOR: an 18-year-old girl (who we think is from Minneapolis!) who selflessly gave the gift of life.
I’d also like to mention that Reese’s neutrophils are 740 tonight! (She needs three days above 500 for official “engraftment”, grow cells grow!)
Now I’m going to push my bed up against Reese’s so I can be just-close-enough that I can touch her, but not-so-close that I steal her covers!! Good night.

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