Clinic visit

Malcolm went to clinic yesterday but not for his final treatment. We learned last Friday that they have scheduled OR time for next Monday January 17 to give him his final treatment, do the bone marrow biopsy and remove his central line. This is better for Malcolm as it is one sedation instead of two. The whole thing starts at 8:00am so we must be at the hospital by 6:30am - good thing we live so close!

Yesterday Malcolm had his dressing changed, a CBC and saw a doctor. The dressing change went well - hopefully our last one ever!!! His ANC surprised us by dropping a bit to 900. The doctor said this is not unexpected given that he has the two treatments into his spine following his intensive round of chemo last month. While the drug shot into his spine primarily remain in the spinal fluid, some of the drug can cross into the bloodstream and so affect his counts. His hemoglobin and platelets were good at 118 and 227.

We discussed with the doctor Malcolm's followup plan. Basically he will have bloodwork done and see a doctor monthly for the next 18 months and less frequently after that. Some of the monthly doctor's visits are with our pediatrician instead of at the clinic. The primary purpose of seeing a doctor is to have a physical exam which includes feeling his spleen and kidneys and also his lymph glands. He will be followed until he is an adult, mainly to check for any late side effects. If he were to relapse, it will likely occur within the first few months and after 18 months relapse will be very unlikely. Relapse in general is very unlikely as only about 5% of kids with Malcolm's type of leukemia (AMKL-DS) relapse. Also, kids who relapse tend to be older at diagnosis. Malcolm was under two years of age at diagnosis which is a very positive prognostic indicator.

So we are almost done! For those of you in Ontario, mark your calendars because we are coming home February 6 - March 10 (well, the boys and I are coming home... - Jan will join us part of the time as work permits).

Today we are celebrating Grama Rainey's birthday. Donovan is pretty excited that we are having a little party for her tonight.

Mary Ellen