What Next if BMT failed?

My 2 and half year old kid received a Bone Marrow Transplant at The Aga Khan University Hospital Karachi Pakistan during last week of December 2018.. His donor was my 9 year old daughter who is 10/10 complete HLA Match.. He was discharged from hospital on 4th February 2019.. His Hemoglobin declined to 7.5 on 25 March so he received Blood Transfusion.. After two more months his Hemoglobin dropped down to 6.5 during last week of May and received another Blood Transfusion.. this is now 170 days post BMT...

His Donor Cell Chimerism now shows only 21% donor cells.. We are completely lost now and don't know what to do.. He is otherwise clinically fine except Occult Blood in Stool is found when tested in laboratory.. however doctor do not suggest any specific medication for this.. he is taking Cyclosporine, Acyclovir, Fluconazole and Medrol.. Will he gradually return to his condition which was prior to transplant ?

any one knows if we should opt for second BMT or not and a good center which could treat and manage it?

Dear Kaleem,

From my experience, i suggest to get a consultancy from Dr. Sunil Baht in Narayana Health Bangalore India.

I went to several countries and consulted several doctors but finally chose  Dr. Sunil

He is brilliant and very professional, heading a team of experienced staff.

I wish you all the Best

Dear Fahed.. Today I contacted Dr Sunil Bhat via email and he replied that as this would be the second transplant of the kid so they will use reduced toxicity regimen.. I do hope that it will work as we go to one of the best doctor in this field. We were even planning to go to Dr Sunil for the first attempt but somehow we ended up somewhere else.. I have also read on several academic papers that it would be better to delay for at least one year if feasible.. so we are planning to do it when two years will pass to his first transplant so that it becomes less risky.. If possible then please kindly share the details of cost in your case so that we get an idea about that..