Some numbers are too low and some are too high. John's platelets fell to 19,000 so he received a platelet transfusion; they were up to 31,000 this morning. We have to get the platelets up to about 50,000 for a surgical procedure John will have Monday morning.
The CMV numbers increased between 5-6 fold which is very concerning. While the numbers are high, John doesn't appear to have an active infection. A combination of three meds will be used to bring the virus numbers down and to protect against an infection of the lungs or gut.
A catheter will be implanted through the jugular vein on Monday morning so John can begin photopheresis which is a treatment used to treat his graft v host disease. John's blood will be removed, separated, treated with a chemical and then exposed to UV light and returned to his body. The UV light activates the treated cells and if all goes well, those cells can no longer attack John's proteins and the gvh disease should greatly diminish. If that happens, the immunosuppressant drug being used to treat the gvhd can be cut back. If the immunosuppressant drug can be reduced, John's new immune system can get the CMV under control. If all goes according to plan, the gvhd and the CMV will both be under control.
The good news is John is feeling well, is doing great in physical therapy, is eating like a champion and is tolerating all of his treatments well. It seems we will be spending Christmas in the hospital this year and our best gift will be for these new treatments to work quickly. If you are from our area of the world, stay safe during the rain/high wind storm this weekend.
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