Day +25

Sunday, November 3: Saw the ID Doctors due to the extreme fevers and chills. There is consideration of Engraftment Syndrome or GVHD because of the ongoing fevers and significant amount of diarrhea. They began treatments of steroids for the ES/GVHD until they can determine the cause and because all of the bacterial and viral tests came back negative, the fevers are coming from something other than those. They have also stopped the Filgrastim as the ANC is over 1000 and could potentially be a cause of the fevers. The kidneys are extremely angry from either the high fevers or one of the antibiotics that is given to prevent bacterial infections or the one that is used to prevent GVHD. This drug is Tacrolimus and is very toxic, they monitor the amount in the body by doing a blood draw to test the trough approximately every other day. Platelets: 5 Hemo: 6.7 WBC: 1.55. High fever: 103 significant stool output; need to determine whether it is due to chemo, GVHD or Engraftment Syndrome.