Antsy, jittery, impatient.
All good ways to describe what I am feeling right now, but mainly I feel like we are stuck. This is our second delay for Ann starting the next round of enhanced H-CVAD. That means we've lost a week waiting for her liver enzymes to fall to acceptable levels so that the next round doesn't do permanent damage. They are trending in the right direction (e.g. Tuesday they where 7 times normal and Thursday only 5), so that seems to be moving in the right direction.
Ann's counts continue to recover back towards their pre-relapse, post-transplant normals as the baby stem cells fight to rebuild their house. True to form they are once again cranking out the platelets (194 K/ul yesterday). The only thing that has not made a significant recovery is the reds, but that's to be expected as they take the longest time to mature of all the blood cells.
We did have a little heart stopping moment yesterday when we got Ann's CBC back and 1% blasts showed up on it. That finding was accompanied by 4% metamelyoctyes also known as neutrophil progenitors. Adding everything up our doctor believes that both of these are products of marrow recovery and not leukemia. Basically, the baby stem cells are reproducing so quickly that they accidentally shoved some cells out of the nursery and into the blood stream that wouldn't normally be there. I should point out that this has happened to Ann twice before. Once during one of her first rounds of chemo back before the transplant and once post transplant.
I would feel better about it if we had a definitive finding like the PCR or FISH tests from her most recent BMB. But they weren't ready as of yesterday, so we'll have to wait until our next clinic visit for them. That will be Tuesday and hopefully by then the liver enzyme issue will be resolved to the point that we can advance forward.