Evening September 16 Day +23

Although this is not where we want to be, it is, at the same time, a safe haven. Ron was moved to a different room late this afternoon; actually just down the hall but into the Bone Marrow Transplant area where all the expertise for adult BMT is. He is receiving IV steroids every 12 hours, and the doc told him if his GVHD symptoms subside well, he should be able to back off from the dose of steroids. His symptoms are an entire body rash and diarrhea. He is on a clear liquid diet. A biopsy and images were taken during his flex sig scope this morning. Besides the skin and GI tract, GVHD can affect the liver, but his blood tests indicate that has not happened. The skin biopsy Monday did verify that he has graft versus host disease. Some disease is good because it shows that the new cells are attacking any remaining leukemia cells. But the GVHD symptoms show that they are also attacking good cells, so he continues to take his anti-rejection meds, and the steroids treat the effects of the new cells attacking good cells. It is a balancing act with the meds, and this will continue for some time. It is the main reason Ron is required to live close by for 100 days after his first discharge. The goal is to be weaned off most meds by December.