After Transplant

Hi Everyone,
My son is now more than a year post transplant.
We have been lucky to have no GVHD and to get 100%
donor cells.
I wonder where all other transplant patients go.
My son has not needed a transfusion for a year now but his Hb stays between 8 and 9. Is this normal?
His donor was his thal minor brother with a Hb of 12.4.
At first they told me it was maybe bc of immune and hence bone marrow supression.  He has been off those for 3 months now.
Last test his ferritin increased by almost 200. I know it could have risen due to infection but worry about it being increased gut absorption bc of his low Hb like in thalassemia intermedia.
How long does it take for Hb to go up after stopping all myelosurpression?
Zahra

The curethalassemia.org FAQ page states that the expected Hb after a BMT from a minor should be in the 10-12 range.

After a successful BMT,the child will be thalassemia minor/trait carrier?
Yes,the child will be a thalassemia minor carrier,with an haemoglobin level around 10-12.

It may be that the immune suppression is still responsible for the low Hb. I would think the final outcome should be an Hb similar to his brother's.

Dear Andy,

Thank you for your reply. I hope it is correct and his Hb improves but until then do you think I should restart him on the supplements he was on before transplant?
Like the homeopathic medicines for preventing splenomegaly and wheatgrass and IP6 to prevent complications from prolonged low Hb?

Zahra

Yes, the supplements may help raise the Hb and the IP6 will help with the remaining iron load. Whatever you give him, add B-12 sublingual tablets to the mix.

We are planning for BMT for our 1 year and 10 months old. Is it possible to ask where BMT for your child was conducted?

Johns Hopkins Baltimore, Maryland, USA

We performed BMT of my kid at The Aga Khan University Hospital Karachi Pakistan... His is again dependent on blood transfusion unfortunately..

Update. My son is now almost 3 years out from haplo BMT. He is doing well though Hb is still around 9. Sometimes a little less sometimes a little more. Doctors give hope that it could increase as he hits puberty. Lets hope so. They also say this Hb shouldnt limit anything in his life except maybe avoiding very high altitudes.
He seems to be unaffected.  Boasting yesterday about being the fastest runner in his class! His energy levels are good though he looks pale. Especially his lips.

Thanks Zahra for updating us. Glad to know that your kid is fine and doing well. Unfortunately we performed transplant at Aga Khan University Hospital in Pakistan and it was unsuccessful. Is it possible to know who was the pysicial of your kid at John Hopkins and how much it would cost there? We might need your guidance to contact a good doctor there and present this case. We are planning for a Second Transplant in few years and as it may be more risky therefore we want to do it from the best doctor..

Dr Kenneth Cooke.
Cost varies alot depending on what problems arise, how much hospitalusation is needed,etc.