This morning was a “sedation” day, meaning that Harrison would be sedated for a spinal tap. Dr. Weston did a lumbar puncture and pushed a chemo drug known as methaltrexate. Harrison also got a dose of cytarabine. While there is no sign of leukemia in Harrison’s spinal fluid, researchers have discovered that leukemia cells love to hide out in the central nervous system (CNS). In the past, before treating the CNS, kids would come out of remission quite quickly after induction when the cells in the CNS began to reproduce. The chemo in the spine is both to prevent the spread of leukemia to the brain and to prevent a relapse in the event some cells slipped in. Unfortunately for Harrison, due to his stroke there most certainly was some leukemia passed to the brain.
There are several blood count numbers that the doctor tests each week. The results of these tests determine the level of medication given. For example, if the white blood cell count is too low, then Harrison might take a lower dosage of a particular drug. Once the numbers return to a safe level, the chemo dosage rises.
One number chemo patients always look for is the ANC, Absolute Neutrophil Count. Neutrophils are the cells that fight infection. A count of less that 500 (written as .5) is dangerous, and means the patient is neutropinic, and really should not be around other people.
The chemo kills both good and bad cells, so low numbers are to be expected. But the treatment must be managed to ensure the body can produce enough good cells to get the numbers back in order. If the numbers do not bounce back, then something isn’t going right.
At the clinic visit today here were Harrison’s numbers:
Hemoglobin: 9.1 (normal is 11.5-15.5 – less than 8 requires a blood transfusion)
Platelets: 249 (normal is 150-440 – this is a great number)
ANC: .5 (normal is 2.0-7.5)
While Harrison is neutropenic, these numbers look really good according to Dr. Weston.
Thanks for your continued prayers for Harrison.