Day at the Clinic

Ava's been at the clinic all day. Her CBC continues to look good, including the white count and ANC coming up a bit. Her blasts remain at 0% (hooray!)

She drank her contrast dye without any issues (yay!), but was hungry while waiting the 2 hrs before the CT scan would be done to check for fungal infection. She will also have a spinal tap to check for any blasts in the brain/spine, as well as get her first bone marrow biopsy to check for any blasts within the bone marrow. (If you recall, the blasts have only reflected what's in her peripheral blood, not in the actual marrow).

Thanks for your continued prayers for healing, stamina, patience and favorable results of no blasts in the marrow or spine/brain, as well as no fungal infection or unexpected complications. Thankfully, Ava's platelets look good, so no transfusion needed today.

I'll update as soon as I hear more.

Update (5pm): Good news! Ava is on her way home after having her CT scan, lumbar puncture and bone marrow biopsy. Everything went smoothly, and it seems that they were able to get everything on the first stick! Results for all these tests may come back tomorrow, we'll see.

The plan: They will assess Ava's level of "minimal residual disease" (MRD), which shows any low-level cancer activity despite Ava showing no symptoms. If she does not have any MRD, then they will continue with the AML treatment since that seems to be working. If there is any evidence of MRD, then they will switch to ALL treatment as planned, projected to start on Monday.

If Ava's MRD is negative (no residual disease), she is considered to be in remission. However, it's impossible to predict if/when she might relapse. The doctor feels that a bone marrow transplant is a strong possibility because it took so long time for Ava's blasts to come down. Still, this will be reassessed as treatment continues. They will see how Ava responds to the (AML or ALL) chemo and look at the whole picture before deciding on a transplant - but at this point, BMT it is a strong option for Ava.

Thank you again for all of your prayers, and especially as we gear up for Round 2 of chemo. I will update the Google doc in the next couple days as we get a better idea of what may be needed. Thank you!