Well, they finally think they have Alyssa’s rash figured out. She has graft vs.host disease (GVHD). They still think it started as an allergic reaction to her antifungal, but then this cascade effect started. She received viral specific T cells (VSTs) prophelactically as part of a clinical trial. To recap, these VSTs are actually Eric’s T cells that have been “re-engineered” in a lab to fight specific viral infections which can be very harmful to BMT patients. They normally wait to give them if/when a patient tests positive for certain infections. In Alyssa’s case, they just went ahead and gave them to her to see if it would actually reduce the odds that she would ever get these infections. But in doing so, the T cells that were given to her 2 weeks ago have now caused a mild case of GVHD. And buried in the fine print of her consent form, it does say there’s a small probability that this could happen (nothing like reading this after the fact) So, they are going to have to give her steroids now as that is the only way to treat GVHD. But they are going to give her the smallest dose they can to treat the disease, but not “ruin” the potential benefit of the T cells. (Crash course: T cells are needed to fight foreign invaders in your body...viruses, bacteria, cancer cells) Alyssa’s T cells were destroyed prior to her transplant when she went through radiation and high dose chemo). They still also have more of Eric’s VSTs banked in case another dose was needed in the future. Her body will eventually start making them on its own again, but that won’t happen for probably at least 6 months, which is why BMT patients are so vulnerable to infections. And some GVHD can actually be a good sign that the body has recognized any possible remaining cancer cells and is attacking them. Alyssa’s GVHD is considered a grade 1 (out of 4) since its only prevalent as a rash on her skin. And if this is a 1, I can only imagine how awful a grade 4 must be. So the plan is to start the steroid today. They will keep this dose for 48 hours and then see where she’s at. Hopefully, they won’t have to bump up the dose to see improvement. But at this point, we are just really glad they’ve figured this out and there’s a plan to treat it. Five days of “Lets just see how she looks tomorrow” was getting really frustrating.