Day -6: Lingering Lymphocytes

Kylene is at home with Ethan today, and she has been getting started moving things out of storage and into our new rental home. Meanwhile, I'm on hospital duty for the weekend.

The other day a test and retest seemed to indicate that Jacob's heart might be enlarged. A doctor doing rounds this morning told me that the results of a more accurate test came back and his heart is apparently not enlarged after all. She commented that she noticed the hole in the top hinges of his heart, which had been discovered previously. I believe we mentioned before on the blog that while it sounds scary, a hole in the top hinges is usually not a problem, but Jacob will probably have annual visits with a cardiologist just to be sure his heart is working properly.

A little later this morning, one of the BMT doctors came to speak with me. He said that the quantitative test results on the adenovirus levels came back, and thankfully the level was so low that it didn't even register (the test only gives a result if the count is greater than 100). This was the good news. The bad news was that Jacob still has lymphocytes (a type of white blood cell, one of the body's defensive cells) in his blood, meaning that the Campath unfortunately did not eradicate them entirely. Prior to receiving a bone marrow transplant, all lymphocytes must be destroyed to ensure that the body does not attack the new cells. The doctor explained that the only way to effectively resolve this problem is to give Jacob an extra 200 cGy (200 centigray, also written as 2 Gy or gray) of radiation, ideally 5 hours apart from the 200 cGy they were already planning to give him on the transplant day, to kill the remaining lymphocytes. If the radiation oncologist prefers, the radiation treatments could be done a day apart, but the BMT doctor says two treatments 5 hours apart would be ideal. Four gray is a lot of radiation compared to X-rays or any natural exposure to radiation, but it's still pretty low compared to many types of radiation therapy.

As always, thank you for keeping Jacob in your prayers. Tomorrow (Sunday) we will be fasting for Jacob in addition to keeping him in our prayers throughout the day. You are welcome to join us in fasting for him, if you wish to. For more information on why and how we fast, you can go here and click on Additional Information, then read the sections titled "Purposes of Fasting" and "Fast Sunday," respectively.