Tomorrow is a go

Yesterday it snowed and then warmed up to well above zero so it was pretty slushy out. That did not stop the boys from having a great time shovelling and testing out their new sled in our backyard. It is a good thing we did all that shovelling yesterday because it froze overnight and has stayed below zero today so everything is quite icy.

Malcolm went into the hospital for bloodwork today. The clinic was not open so we had to go to the inpatient unit. Malcolm had his hair freshly cut last night so got lots of compliments on it today (I don't have any pictures yet so that will have to wait for another day). Malcolm's bloodwork shows that he is just barely ready for his next round - ANC is 1100. Hemoglobin is 109 and platelets 351. So all of his counts are recovering and he will start his final round tomorrow. We will be outpatients as this round is simply three lumbar punctures to inject chemo (cytarabine) into his spine. Tomorrow is the first of the three and he will be sedated. The hardest part for Malcolm will be not eating or drinking all morning! (the sedation usually occurs around 1pm).

The main purpose of injecting chemo into his spine is to ensure that there are no cancerous cells lurking in his spinal fluid or central nervous system (CNS). It is fairly common for patients with AML to have the disease in the CNS. Interestingly, because Malcolm has Down syndrome it is actually very uncommon to have any leukemia in the CNS. Because of this, there is a newer treatment protocol that is being studied which reduces the number of injections into the spine from 7 to 2 in total (because after all, who wants to inject toxic chemicals into the spines of babies unless it is absolutely necessary?). Unfortunately, Malcolm did not meet all of the eligibility criteria for this study so he is still on an older protocol which requires a full seven injections (he has already had four injections in earlier rounds).

At any rate, we are almost done treatment. Two weeks from tomorrow they will inject the final dose of chemo into his spine and do a bone marrow biopsy to confirm that he is cancer-free. We can't wait!

Mary Ellen

I should also mention that Malcolm weighs almost 26pounds - 25 pounds, 15 ounces on the scale today.