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Spinal Tap and Bone Marrow Today.


7-8-2008

Stressful days. Jaymun has had intermittent high fevers, and his tummy is very sore. He likes to sit around most times, when he moves around he grunts from the pain.

While we are waiting for his marrow to recover (praying he will be in remission there) and watching his CNS numbers come down (praying they come all the way down) I have been sifting through information and settling on doses for a herbal support "regimen". More to follow on that later.

Yesterday one of the docs showed me a really cool diagram that explains the pathways of blood cell development.

Blood Stem Cell Development Pathway



Compare that to this simpler diagram that shows the Leukemic Stem Cell hypothesis.

Leukemic Stem Cell Reproduction Diagram


We are fighting the battle on several fronts here, bone marrow and CNS, and then infection control
...as his marrow hasn't recovered yet.


Today his CNS nucleated cells went up (bad) from 4 to 5.


Does that mean the methotrexate (started 6/27) like the earlier Ara-C (5/9 - 6/10) has an effective limit?
(because of resistant cells?)

Today his marrow aspirate was either hypocellular (very few cells) or aplastic.
Lymphoblasts - 0
Lymphocytes - 6
Plasma cells - 3
Monocytes - 0
Histiocytes - 90
Myeloblasts - 0
Promyelocytes - 0
Myelocytes - 0
Metamyelos - 0
Bands - 0
Segs - 0
Eosinophils - 0
Basophils - 0
Erythroblasts - 0
Normoblasts - 1
Spicules are present
but they are "empty" and
consist mostly of
histiocytes, many which
contain hemosiderin.
No increase in blasts seen.
Bone Marrow Aspiration - cortical bone, spongy bone, marrow


Example of what hypocellular marrow looks like:

Hypocellular bone marrow

It is already about 25 days out from his last chemo so you would think there would be some recovery.
However, we had started the 2-CDA/Idarubacin chemo when he was barely recovering from his high-dose Ara-C.

At least his marrow is not full of blasts - I think that was the main reason for doing the aspirate.

More later...

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