remission

Gabriela is officially in remission today. That means two things: the fraction of immature white blood cells is about normal (below 5%) and the counts of healthy red blood cells, white blood cells, and platelets are about normal. This is what we were expecting, since almost all kids are in remission after one month of treatment, but it is an important milestone. The first month of chemo is like a really effective crash diet. The rest of the (two years, probably) of treatment will be about "keeping it off."

We also got good news about genetics today. She has a mutation called the TEL-AML1 fusion, which is associated with excellent outcomes. If the results of today's biopsy are as expected (if she has < 0.1% leukemia cells remaining), she will be placed in a lower risk category. This was a lucky break, since the TEL-AML1 fusion is relatively uncommon.

This is the last day of induction, the first phase of chemo. In one week, we will start phase two: consolidation. Gabriela will go off the decadron, and supposedly her power eating will come to a screeching halt. It will be replaced with a new drug: mercaptopurine, but in the meantime, we have no medicine except an antibiotic. So that's a nice break.

One last thing: I found out today that I had misunderstood what was going on with Gabriela's immune system until now. I mistakenly thought the chemo had wiped it out. In fact, the decadron and vincristine don't hurt the immune system; rather, it was the leukemia that had crowded out all the infection-fighting white cells. There are chemo drugs that suppress the immune system, but Gabriela will be getting those later.