Signs of engraftment?

Hi all,

• We had the good news today (16 days after the transplant) that Roger is starting to produce small numbers of white blood cells and neutrophils (the kind of WBCs most important for fighting infection).  This is the first indication we’ve had that the new stem cells are starting to function in Roger’s marrow and that engraftment may, therefore, be occurring.  Because Roger has been feeling progressively worse over the past two weeks, this good news was a welcome relief. 
• The medication and TBI-induced side effects persist.  The most annoying of these is called Hand and Foot syndrome, which has made his hands and feet quite sore and walking a real chore.  To address this, the docs have taken Roger off the immunosuppressant drug cyclosporin and substituted tacrolimus in its place.  We should know within 3-5 days whether this change will relieve some of the discomfort.  The team is also continuing to try to identify and treat the causes of his continued elevated blood pressure.  They also switched Roger’s pain medication (again) from IV Dilaudid to oral oxycontin, in an effort to decrease the drowsiness associated with the dilaudid.    
• All in all, we’re feeling hopeful that the healing has started.