Long day today, and I'm drained so I'll try to be brief. Ann had two groups of tests today, one to determine if she was in remission and the other set to see if she was strong enough to undergo another transplant.
The transplant testing went like clock work. Her heart function is particularly strong. However, her lung function is only about 67% of what it should be. That's probably a combination of low hemoglobin from the previous weeks chemo and the cumulative effect of those same cytotoxic drugs. Bottom line is that she is strong enough to exceed the minimum standards that MDA has set for a transplant. So everything is good there....well almost. It is troubling to hear that the love of your life is operating with diminished lung capacity. That's a momentary concern though, because I know it will reverse itself once Ann begins to recover more.
Ann also had a BMB this morning to determine it the leukemia has been thoroughly thrashed. Later this afternoon when we meet with Dr. Thomas, she told us that the pathologist found 4% blasts in the specimen smear. That's good news, as its within the normal range of 0% - 5% blast cells that should be in healthy marrow. PCR and FISH tests are still pending on the biopsy sample, but considering those same results from last weeks BMB, Dr. Thomas doesn't anticipate any surprises there.
So is Ann in remission? Simple answer is "practically almost". MDA defines remission as a normal population of blasts in the marrow, an absolute neutrophil count over 1.5 K/uL and platelets over 100 K/uL. Ann got the first one, and the second, but her platelets were only 49 K/uL today. Dr. Thomas seemed extremely pleased with Ann's progress non-the-less. One of the antibiotics Ann is on right now is known to suppress platelets and she takes her last dose of that drug tonight. So Dr. Thomas thinks that Ann's platelets will have fully recovered by tomorrow or the next day. She did tell us that Monday or Tuesday Ann will be headed back to the hospital for round two of the enhanced H-CVAD protocol.
Hopefully after that it will be time for transplant.