Day +15

The ongoing question is what Zoe's fever spikes are due to: GVH, or....?

A theory that Jeff came up with today was whether the platelet transfusions are causing an inflammatory response in her body. One thing recently discovered through lab tests was that Zoe has quite a few antibodies built up against the platelets transfused into her--a good explanation as to why her body purges them as soon as they are introduced.

They found a couple donors that were HLA matched to her (remarkable, since they told us that her HLA type is very rare), had them apherised, and transfused Zoe with those platelets over two sessions yesterday. No fever.

Then, a "pooled" platelet transfusion (where platelets from more than one donor are mixed together), and she had a fever within a short time afterward. After Jeff brought up his theory, the nurse did a little charting--looking at platelet transfusions in conjunction to the fever spikes--and found that there was a possible correlation.

Even Manley said that this could certainly be an explanation.

Not to make it sound like such a thing wasn't on his radar--he said that it was one of the questions in his mind. I really like how he weighs all the possibilities and doesn't go blazing into decision that will have long term repercussions. He knows that GVH should be nipped in the bud at this stage, but also doesn't want to put Zoe on prednisone unless absolutely necessary.

So, we still wait on that one.

Zoe is due to have two more transfusions from a matched donor. They will be watching her closely to see how she does.

On other fronts, it was another great day as far as Zoe mood went. A lot of talking, smiles and chuckles. Lovely, lovely!

Jeff and I are looking to go back to work on a limited schedule next week (as long as things continue to trend along the same trajectory). Clients and others who would like to get back in our books, feel free to call or email. Otherwise, don't be surprised if you hear from us. Thanks!