"The first time I met Caroline, she looked OK, and we started putting things into place for the transplant," Dr. Boulad explains. But as the day of the transplant drew near, Caroline began suffering from fevers and abdominal infections, which can adversely affect the outcome of a transplant. "I was becoming nervous that these infections were going to get worse if we did not proceed to transplant," he remembers. "In a way, we had to bite the bullet and go ahead."
According to Dr. Boulad, there are five factors that determine the positive or negative outcome of a transplant. They include the following: one, the type of disease; two, the stage of the disease; three, the availability of a matched donor; four, the status of the vital organs (heart, lungs, etc.); and, five, the presence or absence of infections.
"In Caroline's case," Dr. Boulad says, "her disease (MDS), her disease status, the availability of a matched sister, and her vital organ function were all overall positive factors. She did, however, have infections that made us a little nervous going to transplant as we were treating them."
Fortunately, Caroline responded well to the blood stem cell graft, even though she did suffer from a number of worrisome complications, including infections and serious rashes. With aggressive supportive care, all the complications were eventually resolved, and Caroline recovered and was discharged from the hospital six weeks after her transplant.
"Our entire raison d'être as transplanters is to cure these kids from the lethal diseases afflicting them," Dr. Boulad says with matter-of-fact conviction. "When it works, which is thankfully the majority of the time, we are the happiest people on earth. When it works and the patients stay in touch and are as awesome as Caroline and her family, we are even happier than the happiest people on earth."
