I had my weekly doctor's visit today. The mixed news is that I may or may not be working on some GVHD. GVHD, or graft versus host disease, is when my donor cells react against my body cells. All of the cells in your body have protein markers, called the human leukocyte antigen (HLA), and this protein identifies your cells as being "you." This is part of how the immune system identifies viruses and other infections and knows to attack them. I'm perfectly matched with my donor on the major antigens, but there are still some genetic differences between my cells and his cells, and this can cause his cells to identify my cells as "invaders" (whatever, he's the real invader). And because he is my immune system now, that means his cells (the graft) can attack my body cells (the host). Make sense? It's a little confusing. Basically, because I have the cells of someone else living in my body, there can be problems.
In the first 100 days after transplant you get what is called acute GVHD, with acute meaning it comes on quickly and can get serious very quickly, so it's really important to keep a close eye on things. The main sites for acute GVHD are the skin, digestive track, and liver. I might have a little bit of skin redness just starting, it's hard to tell, and I might have some GVHD in my gut; again, hard to tell. My doctor thinks it's 50/50 that I might progress to GVHD.
While this is an annoying problem, I'm wondering if it's secretly a good thing. GVHD oftentimes goes hand in hand with GVL, the graft versus leukemia effect. Part of the reasoning behind getting a bone marrow transplant is that the new immune system will be able to identify any remaining leukemia cells as being really bad and destroy them and keep them from coming back. The two effects aren't completely linked; there are people who never get GVHD and never relapse and there are people who get GVHD and still relapse (like me). In any case GVHD definitely indicates some kind of anti-my cell effect. My leukemia relapsed in my gut, so maybe if I get a little gut GVHD it wouldn't be such a bad thing?
See, I'm working on being optimistic and hopeful!
In other news, my brother is leaving to go back to school tomorrow. Finally! I will no longer be prisoner to the terrible TV shows he likes to watch! He likes to watch all of these gross boy shows, like this thing on MTV, I think it's called Wild Boys? Disgusting. Last night was the low point when he decided to watch Ultimate Fighting. It was truly revolting. Chick flicks and ANTM, here I come!