Grade III GVHD of the gut

We have confirmed via biopsy that Xander does have grade III GVHD of the gut. We have also confirmed that he does NOT have CMV in his gut. GVHD is very serious if not treated, but of course, it is being treated with steroids and enteracept and was being treated before the biopsies came back today. His blood counts are doing fine.

He also has some hematomas in his colon, these are just like blood blisters, seen when a person has low counts for a long time and should heal on their own. Most importantly is to keep everything moving smoothly (which currently is NOT an issue).

So, after all this, today he has been allowed to eat 12 oz of broth only (yes, only 12 oz during 24 hour period). Unfortunately  he has already shown that this is a bit problematic, with a large stool. So, we are literally taking it ounce by ounce and stool by stool. He has had no discomfort or emesis with the eating so far today, so that is good.

This process is like introducing food to a baby... so little by little we will see what he can tolerate.

Dr. Connelly has recommended moving into ECP for treatment of the GVHD. If you are really interested to know more about this you can read about it here - the basic idea involves collecting leukocytes from peripheral blood. These cells are exposed to a photosensitizing agent, 8-methoxypsoralen, and are then treated with ultraviolet (uv) radiation, after which they are re-infused. This procedure, which results in crosslinking of pyrimidine bases in dna, produces massive apoptosis of the treated cells, thus reducing the GVHD reaction. This would likely start next Tuesday or Wednesday and is about 2 times per week.

Thank you all for your prayers,

Emilie