Day 9 – Engraftment syndrome

Hi, Brett again.  Do you remember those pesky fevers that I wrote about yesterday?  Well, they are still hanging around.  Jessie was flirting with 104 for the entire morning.  She took some Tylenol around 11 a.m. as a premedication for a blood transfusion and by 12:45 she was down to 102.  She also has a bit of rash which is hard to see with the untrained eye over most of her body.  The docs here keep testing and testing to make sure Jessie doesn’t have an infection that could be causing the fever.  They also changed antibiotics in case she was having an allergic reaction.  The third possibility is called engraftment syndrome.  What is engraftment syndrome?  I don’t know.  But, I can relay the limited information that the docs have described to me.  Engraftment syndrome is unique to cord blood transplants and for some reason the new cells cause a fever and a mild rash.  That’s all I have.  Sorry.  I’ll ask the docs more questions next time I see them and try to update this.  Engraftment syndrome is temporary and does not affect the transplant.  It can be treated with steroids and is typically under control within a few days.  But, when you have no immune system, they do not take the possibility of an infection lightly, and they delay treatment until they are as sure as sure can be that there is no hidden infection.  We are almost to the point where they will treat it, but they need one last chest xray to rule out infection.  So, until they find an infection or decide to treat her with steroids Jessie will be feverish and uncomfortable.  Sucky, but that is what’s happening…  As far as her blood counts, the white blood cells are the same as yesterday and neutrophils went down to 90.  I hope to bring you some better news soon. 

UPDATE : Jessie got her first dose of steroids tonight (Friday) so she should be feeling better soon.   I asked the doc more about engraftment syndrome and he said the "new cells are announcing her body that they are here."  Now that's medicine!  I'm sure the Jessie's research doc will give me a better answer and maybe I can try to explain it then.