Day +4: How do we know the cells are growing? / A fragile immune system

Today Nadia had a blood transfusion. Thank you Donors!

How will we know that the new cells are growing (engraftment)?

According to our hospital handbook, it usually takes between 14-21 days before there are signs of engraftment, which means Nadia will start making her own blood cells and the counts start to go up. But since Nadia had a cord blood donor, they told us that it will likely take a bit longer.

The white blood cells (including neutrophils) are usually the first to grow, and platelets come last. We are told to expect the blood counts to go up and down over time, and this is normal. Once her neutrophil counts start to increase, Nadia will be better able to fight off infections.

White blood cells (including neutrophils) are essentially our immune system. When Nadia’s immune system starts to grow from the donor stem cells, it will be brand new. Her new immune system will actually be more delicate than that of a newborn child. This is because newborns have some residual antibodies from their mother’s immune system. These antibodies don’t last forever, and babies continue to get some from their mother’s breastmilk, but they certainly help and give the new immune system some ‘breathing space’ where it can be exposed to some viruses, and built up its own antibodies while mom’s antibodies do the dirty work. Nadia will not have any of these antibodies. Her new immune system will actually be more delicate than that of a newborn. She will be fending for herself.

Nadia bossing mom around, telling here where the decorations go.