More Leukemia

            Yes, bad news this week. The bloodwork on Tuesday looked good; the white blood cell count had risen from 2 to 3.7. But Tuesday evening Dr. Chen called: 30% of those white blood cells are “blasts”, that is, leukemic: immature cells that have gone awry.

Today David had an echocardiogram (an ultrasound of the heart). His ejection fraction, the percentage of blood that is ejected from the heart chamber at each heartbeat, is 43%. That’s an improvement from the 36% at the end of May, but not the 58% a man of his age usually has. One of the very toxic chemo drugs David was given, daunorubicin, can cause heart damage. 

            Dr. Amir Fathi, the “leukemia doctor”, (Dr. Chen is the “transplant doctor”.) spent a long time discussing David’s situation with the three of us. It’s very serious that the leukemia has returned. Because of David’s young age, Dr. Fathi is considering aggressive treatments. He will investigate clinical trials and see if David qualifies for any of them. The heart damage may disqualify him. He will also consider conventional treatments: more chemotherapy. 

            Amy, the nurse, took many vials of blood today. They will be analyzed to determine what sort of leukemia we’re dealing with now. Surprising to us, it may not be FLT-3; some other mutation may have taken over. I’ll write more about this when the tests come back.

            Many months ago we rented a vacation house on the Long Island Sound, in Clinton, Connecticut, for our week-long Summer Retreat with our children (and grandchild!). We’ll drive there tomorrow. David can’t be out in public, but he can ride in a car and be with family in the house and yard. We will need to return to MGH for another bone marrow biopsy on Wednesday. That’s also the day Annie returns from Taiwan. She’ll be home for eleven days before returning as a junior to the University of Wisconsin-Madison.