Monday, September 12, 2011, Day +19

Today's visit to the Cancer Clinic was more efficient so not so stressful. After Ron's blood draw we went to a new (for us) lounge on the clinic floor. Its atmosphere was relaxing, and Ron slept during the hour wait for his appointment. We met with the 5th doc of the Bone Marrow Transplant (BMT) team and a new PA as well, but this is a good thing..to feel acquainted with several of the doctors. She said that his rash now looks like GVHD--graft versus host disease. Mild GVHD is a good thing, showing that it could be destroying any remaining leukemia cells. This is called graft vs leukemia. At the same time you don't want the donor cells to be too aggressive in attacking the host (Ron) cells. Once the rash is more widespread and if other symptoms present themselves, Ron will go on a stronger steroid medication. GVHD affects the skin first, then can show up as diarrhea and decreased liver function. All of this can range from very mild to severe, so we watch and wait. To this point he has not had a fever. Another skin biopsy was taken to confirm that the change in his rash is GVHD.