My new revelation

It just dawned on my at 4am this morning when I woke up in the middle of the night.  The cluster of low ANC and needing blood and platelets transfusion throughout Lucas's treatment has been (1) in induction (2) in consolidation (3) in second half of DI.  I earlier concluded that AraC hits Lucas really hard and always result in low blood counts for him.   Now I looked in more details, I found the three times we used AraC, Lucas also got either 60mg 6mp or 75mg 6TG(very similar to 6mp).  So my new hypothesis is that Lucas is very sensitive to 6mp/6TG.

My two superheroes

3rd transfusion this week

Platelets dropped from 34 to 20 in two days and the NP doesn't feel comfortable to wait until Tuesday.  ANC 320.  Continue to hold 6mp and oral MTX.  Will resume other chemo next Tuesday.  

Blood transfusion and low ANC

Hemoglobin is 7.2 this morning and Lucas got blood since the nurse practitioner we saw worries that if he gets sick, it would be a lot of burden for his heart.  His ANC dipped into under 500 also (390) and platelets 34.  So after spending 8 hours in the clinic getting blood today, we will go back on Friday to recheck to see if he needs more blood products.  Jianwei and I have been taking turns to take him since we need to go so often.  MWF this week.   Next Tuesday and Wednesday Lucas is due for Vincristine and lumbar puncture.  Obviously when they say chemo hold, they only meant 6MP and MTX.  

Platelets transfusion

Today they had to draw more blood than what a finger poke would be able to give, since they expected plates would be low and not enough blood amount would be hard for lab to get a value.  So Lucas had his rare occasion of arm poke.  The nurse who drew the lab was amazing -- she is the one and only one who can do such things.  I joked with her that she can never take sick leaves or be on vacation!  Still, Lucas cried hard and kept saying "take it out!".   I later asked him whether arm poke is more painful than port access (he sometimes get port access without numbing cream).  He told me he preferred port access since Cindy (the child life lady with an iPad full of games) would be there for port access.  :)  We anticipate more frequent arm pokes since we would like to monitor his liver functions more closely in-between port access.  I will make sure Cindy would be there for the next arm poke so he could associate arm poke with some not-too-awful memories.

So the plates came back as 8 and Lucas got the chest poke for port access half hour after the arm poke.  We got there at 8:30 and left after 1pm.   We need to go back Wednesday again since his hemoglobin is 8.2 today but I didn't feel like he needed transfusion right away as he is still pretty active and energetic. His WBC is 1.3 and ANC 754.  Chemo hold is still in action.  We probably would see numbers get lower before they get higher.  I'm hoping we have caught this early enough that he wouldn't be wiped out.