06 January, 2011

1/6/11 AM

Everything is going well here.  Robert is still acting lethargic and  looking a bit swollen, but is comfortable.  As the chemotherapy has killed a very large percentage of the Lymphoblasts, he is no longer having any bone pain, which is good news.  Lymphoblast is a term used to describe immature white blood cells in the bone marrow and blood, these cells multiply greatly and do not fight infection.  In a normally functioning environment, these cells for the most part mature properly prior to entering the blood stream. When the numbers of these immature cells increase greatly, swelling inside the bone results in the pain he was experiencing, and damages the normal cells.  In this circumstance many of these immature cells are released into the blood, and are monitored on a Blood Count as "blasts".  The lower the blast count, the better.  A low blast count is a harbinger of the body's cessation of immature cell production.  Robert's blast counts are very low, which is great news as it suggests effective chemotherapy.  If this trend continues, we could expect remission very soon. Neutrophils are the primary infection fighting part of the healthy white blood cell.  A multiplier created from the percentage of segs and bands, which are subsets of Neutrophils, is applied to the white blood count to determine the ANC.  This Absolute Neutrophil Count is the best method for determining the body's ability to fight off infection.  An ANC of less than 1000 is an immune deficiency.  Less than 500 tells of a severe risk for infection.  Robert's is currently around 200,  which is why we can't allow visitors at this time.  

Now, a note about remission, a term which is commonly misunderstood.  Many folks are shocked to hear that remission is imminent, as they believe that word to indicate the end of the road.  Don't get me wrong, it will be wonderful news, and another huge step towards recovery!  However, remission does not mean that the patient is cured.  Remission in our circumstance means that as a result of the treatment, the cancerous cells are no longer found in the bone marrow, and the blood counts return to normal.  As we near the end of the Induction phase of chemotherapy, this will hopefully be the case.  After remission the priority shifts to preventing the cancer from returning, which is why the chemo continues.  Each patient is assigned a risk factor of low, standard, or high risk of recurrence.  As of now, Robert is in the standard risk category.  The next phase of chemotherapy is the Consolidation phase.  The length of this phase has yet to be determined, but is often between 6 to 8 months.  The purpose of the consolidation phase is to reduce the numbers of cancerous cells left in the body.  After consolidation, the final phase will be maintenance.    This will likely take us to the three year mark of treatment.  And the end of this segment, is when folks start throwing around beautiful words such as CURED.