A new sword hanging over us

Most likely this is a false alarm.  Lucas's CBC shows blast = 2 for both yesterday and today.  Blast is the count of immature white blood cells.  A healthy person has up to 5% of blast in his/her bone marrow.  But usually blast in peripheral blood is a sign of leukemia.  Please remember that Lucas has been leukemia free for 3 months now.  Any sign of leukemia cells scares us immensely as that would decrease his chance of survival significantly.  However, the attending doctor told me that for chemo patients who have been in the state of neutropenia and fighting an infection, some of them show blast in blood when their ANC recovers.  Some premature babies do that too as they also have next-to-nothing immune system.  The reason behind that is one's body/bone marrow is trying very hard to get some neutrophils out and in doing so, some immature white blood cells might have come out accidentally.  The attending doctor didn't say he would bet his house on this though.  He just said that if they were concerned, they would let Lucas have a bone marrow biopsy right away.  Instead, they would still let us go home and come back Tuesday (Monday schedule is all packed) for clinic visit then admitted for lumbar puncture and high dose methotrexate.

Later, our own doctor visited us and explained more why they think it's what's called "recovery blast".  Lucas's CBC looks great for someone who is recovering from neutropenia.   Not everybody's CBC shows blast when they recover, but quite some do.  What's most assuring is that they have talked to the pathologist (the one who actually looks at the blood smear) and the blast they saw don't look like leukemia blasts they have in file for Lucas.

So, we will go home and try to enjoy 3 days being home.  Lucas eats better and seems to be doing well.  We will try not to worry about it too much.   Hopefully Tuesday we will see no blast and strong ANC, hemoglobin and platelets.  Please keep your fingers crossed for us!