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Levels slowly dropping after 2nd transplant
My husband had a second transplant Nov 22 and his platelets and haemoglobin has been slowly going down since April. I’m so scared it could be a relapse.My husbands chimerism was 100% 3rd May so not sure what’s happening. I’m so scared I’m sick with worry and at yesterdays clinic the computers broke down so didn’t get any levels to know anymore.
Answers
Hi Beaglegirl,
thank you for reaching out to the forum for support. Hopefully you've been able to get more up to date test results since you posted last week?
As I'm sure you've been told by your husbands BMT team a trend in blood results is more useful than a one off result and there are a number of variables to consider- in particularly, how often the bloods are being taken.
Relapse is a possible cause for anaemia and thrombocytopenia (low platelets) but it would also be common to see the white cell count/neutrophils impacted in this scenario. It can take a number of months for blood counts to recover post transplant and this can be slower if your husband has received treatment for post transplant complications such as graft v's host disease, that may have impacted on the red cell and platelet recovery.
Your husbands BMT team will be able to confirm if any treatments he's received are potentially causing the the blood counts to be slow in recovery. I'd encourage you to speak to them about your concerns and they will (hopefully) be able to provide some reassurance.
Kind regards
Rachel Miller (Anthony Nolan Lead Nurse)
Hi Rachael,
He was admitted again on Thursday as high temp and vomiting. An infection again! Hopefully coming home tomorrow all being well. His Hg after transplant was good then slowly going down I think it hovers around 80-90. They said they don’t want to do a BMB as they don’t know what to do if they find anything in the marrow? Is this normal after a 2nd transplant? He’s feeling well in his self and the doctors don’t seem to worries. I think it’s me over worrying but I just can’t help it.
He’s not coming home as his Hb is now 69 WBC 1.5 and platelets 28. His potassium is low too. I’m absolutely terrified as to what is happening and cannot get to speak to anyone.
Hi Beaglegirl,
His counts may well be affected as a result of being unwell with the high temperature, potassium is likely to be low if he's had vomiting/diarrhoea symptoms. I imagine he's not eaten very well while that's been going on either so they'll likely supplement the potassium with some IV fluids.
I'm sure it is a worrying time for you, particularly when your apart and he's back in hospital. Hopefully, if his temperature is better and he's feeling brighter they can transfuse him and let him home in the next few days.
Kind regards
Rachel