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Chapter 51: Rejection

DEACON

By Sunday afternoon, Angela had developed a maculopapular rash on her neck, ears and shoulders, confirming for me what had become increasingly apparent throughout the weekend, with each new test result. Angela was dealing with graft versus host disease, and it was time to step up her treatment.

"Let's start her on glucocorticoid and cyclosporine." I stood with Jenny just outside Angela's room. "I think we need to be aggressive." I rubbed a spot in the center of my forehead where a headache had been forming all day. "She's getting worse, not any better."

"But we haven't gone full-throttle on her treatment yet. Not really," Jenny pointed out. "Once we get the extra steroids and immunosuppresives on board, she'll probably bounce back pretty quick."

I tried to share some of Jenny's optimism. "Let's hope so." I stared at Angela's latest numbers on the tablet in my hand. "She's young. Generally, we don't see acute GVHD as often in patients under forty. Not with a donor who
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