day 22 - a great day!

We had our first visit at the outpatient clinic today for Day 22 of Ethan's induction treatment. Today he received the same 2 chemo drugs via IV that he has received for the last 3 weeks but we were blessed to get to take a week off from sedation and bone marrow biopsies.

The boys getting ready to head out!

Grandma Sheila and Ethan were matching today in gray sweaters :)

We were thrilled to learn that Ethan's blood counts have soared past the 500 threshold to over 4000! To give you some perspective - when we were discharged on Friday he was at 192 and so still neutropenic. Today, pretty much every blood cell count (white blood cells, red blood cells, platelets and hemoglobin) were all in the normal range which also means he doesn't need any transfusions at the moment - another huge praise!

Ethan was a huge trooper as usual and enjoyed several packs of goldfish crackers while he got his IV chemos. We also talked a lot about next week with his nurse practitioner - Tuesday 2/25 will be Day 29 of Induction and the last day of this first part of treatment. As I've shared before, this is a big day for several reasons - he will be sedated to have 3 procedures: a permanent port will be placed near his heart for future chemo and IV needs; he will receive a lumbar puncture for interthecal (in the spine) chemo; and a bone marrow biopsy. This bone marrow biopsy is the most important in determining what treatment he will have going forward. His marrow will be looked at under the microscope for total number of blasts left in his marrow, and also sent off for special testing to see the Minimal Residual Disease (cancer cells not seen by the human eye) that is present. These results put together with the results we have already received and his prognostic factors at the time of diagnosis are all a part of the puzzle in determining the treatment moving forward.

Ethan waiting patiently while we checked in at the clinic

Our nurse practitioner shared today (what we've already pretty much known) that his treatment will likely be classified in the intermediate to high risk treatment protocol, which is fairly common with T-Cell ALL. This basically means that he will receive more aggressive chemo up front because they have learned through studies and research that this is most effective in preventing relapse. Again, we won't know for sure until results come in after next Tuesday, but it's helpful for us to have a sense of what's coming.

After a busy morning at the clinic we decided to celebrate by having our first family dinner at a restaurant together since diagnosis. It felt good to do something so simple and normal. All in all a good day.

Please pray for Ethan in the next couple of days as the chemo takes effect from today. And please be continually praying for next Tuesday/Day 29. Please pray that Ethan's leukemia will be in remission and for discernment for his doctors in determining treatment and steps moving forward.