Thursday, May 8, 2014

Biopsy Results & Plan

The results of Ava's biopsy came in earlier tonight. Short answer? Ava is MRD positive with blasts of 0.06%. At this point of her treatment, the doctors were really hoping for MRD negative. A positive MRD (Minimal Residual Disease) at the end of induction is not optimal. Unfortunately, Ava was MRD positive for AML treatment and MRD positive for ALL treatment. Because her diagnosis of Biphenotypic Leukemia is so rare, there really is nothing to compare her results to. This adds another level of frustration. Moving forward, the medical team plans to keep Ava on ALL therapy for a couple of reasons:
  1. Ava's cancer cells appear to have more ALL type cells within the blasts.
  2. Ava's quality of life has been SO much better on ALL, and this therapy will allow her to continue to be treated as out-patient. She also did so well (emotionally and physically) with ALL treatment. 
The plan is for Ava to continue on to the second round of ALL therapy, called the consolidation phase. This will involve two months of weekly chemotherapy, with Ava getting different drugs than this first month. She will still be getting chemo on an outpatient basis, but is more likely to become neutropenic (i.e. have abnormally low levels of infection-fighting white blood cells), and require a full day at the clinic for administration, vs. the quick visits she's been able to have this past month. Ava is scheduled to get a port placed on Monday, and chemo on Tuesday. (A port is used to administer the chemo, placed in her chest).

The medical team hopes to get Ava to MRD negative after this round. If that doesn't happen, we will prepare for a BMT this summer, as that would be the best way to treat the Leukemia at that point. However, bone marrow transplants have an overall survival rate of 50-60%, so that puts things in perspective.

It's hard to know how to process these results; I'll share more tomorrow when I get a chance, but wanted to at least let you know the results and plan at this point.

As always, thank you so much for your partnership on this journey. Your continued prayers are deeply appreciated.

9 comments:

Dawn said...

Thank you for the update. We shall join our faith to yours - to see our glorious Lord exalted in this situation.

Anonymous said...

Keep fighting! We're with you!

Anonymous said...

Tks for update. We're praying with you.

Connie C said...

Hi Ava and family,
I don't know you or your family personally, but I came across your blog through Sophie's blog. My heart breaks for you and my prayers are with you. Our God is a big and great God and it strikes a painful joy in my heart to see your faith in Him during this storm. Praying for you all. :)

Mary Klein said...

Continued prayers for all of you.

Anonymous said...

Ava, someone is born with health, but you will WIN it ! Like always, Pray for you!

Jamie Morgan said...

So glad she is able to stay on the ALL treatment because of the quality of life she is able to have on that treatment. A lightened spirit can be very healing in itself. As always I'm planning for complete healing for your family and miraculous peace for the whole family. And Happy Mother's Day, Esther!

Anonymous said...

Hi Esther, don't feel lonely while walking through this tough journey, especially when it looks like so quiet. Keep moving forward and then you will see the light of hope at the end of the darkness tunnel. You are the most beautiful mom I have ever seen. We will keep praying for Ava to find the perfect match and praying for every treatment procedure goes smoothly.

Anonymous said...

Please read this link, an ALL case which may offer some insight

http://www.forbes.com/sites/matthewherper/2014/05/07/is-this-how-well-cure-cancer/