Enterovirus and Next Steps

Ava was at the ER earlier this evening to get nebulizer treatments for a couple of hours. Both girls have enterovirus (the ED68 that's hitting asthmatic kids pretty hard). Ava & Gwen are on steroids and nebulizers to manage their symptoms. Please pray for them, and also for Mike & Esther: Esther is pretty sick and Mike is just starting to have symptoms. Thanks in advance for your prayers.

Looking ahead, Seattle is eager to have Ava out as soon as possible for transplant (e.g., as soon as yesterday). Obviously, this is challenging on a practical level and they recognize that. And as Mike mentioned in his most recent post, the doctors feel there is benefit for Ava to have another round of chemo before transplant. This is because:

1) Ava hasn't had chemo in a little while. It may be another couple of weeks before she can even get out to Seattle, so they don't want to leave her cancer "unchecked" for too long.

2) Ava's residual disease shows mainly T-cell leukemia, and there is a drug she hasn't had yet that specifically targets T-cells. (The drug in discussion is nelarabine).

3) If this new chemo regimen can drive down Ava's MRD any further (to MRD negative even!), that would put her in a much better position going into transplant.

The downside? Nelarabine has some pretty serious side effects (like all chemo). But nelarabine can cause problems in the nervous system such as seizures, tingling/numbness, paralysis, even brain damage (though these are "less common"). Still, the small percentage makes little difference to anyone who actually experiences any of these side effects. On the other hand, the potential to attack the cancer with greater efficacy outweighs the risks here if it means Ava's life.

At this point, we don't know for sure if this is the drug (among others) that they will try on Ava this next round. Ava is scheduled to go in on Monday to begin a 5-day course of chemo, but the actual drug regimen is unknown to us right now. I guess we will find that out on Monday.

It is possible that the Lee family will be out in Seattle in a couple of weeks. We'll have to see what the doctors say about Ava's next chemo regimen (and how she responds), and when they feel Ava would really need to be in Seattle. Please pray that the enterovirus will not hinder her on this trajectory, or anyone else in the Lee family. Of course, we rest in God's sovereignty and great wisdom. His ways are higher than our ways. Please pray for the Lee family to remain in that place of "rest" even amidst very practical busyness. So many things happening and all rather quickly.

They are thankful for each one of you and covet your prayers!