Hemoglobin Goes Up for First Time

Yesterday was another full and eventful day at the hospital. Andrew's hemoglobin level went up on its own for the first time, to 9.9. 11-14 is the normal range, so he could be there soon. His platelets also went way up, to 169,000. 150,000 is the low end of the normal range, so his platelets are normal for the first time. His white blood cell level stayed the same, and is still pretty low at 1.1, but his neutrophils went up from 400 to 600. Over 500 is a level where they feel he is fine to fight infections without antibiotics, so the hematologists cancelled those again. We don't have to meet with them for three weeks now. They seem to be happy with the progress he is making.

In the afternoon we had a follow up appointment with Dr. Levine, the bone marrow transplant doctor we met with back in April. He was pleased with Andrew's progress as well. He told us that, since the same stem cells make platelets, red blood cells, and white blood cells, that his numbers, especially his platelet numbers, indicate that his body has the capacity to fully recover blood cell production. While he didn't completely rule out a future bone marrow transplant, he said that, with the production his body has shown, it is an option they would pursue only if something changed significantly in the future. Even then, he would probably do several tests before even considering a transplant again. Andrew's response so far has convinced him that immunosuppressive therapy, even if we had to do a second round of it, is preferable to transplant for him.

Dr. Levine said that they will probably keep Andrew on his full dose of cyclosporine until his white cells and neutrophils get back to normal ranges, then start to ween him off of it. He is recommending weening him off over a period of time of 9-12 months, slightly longer than normal. He said he does this to be a little more cautious and give his body extra time to reintroduce t-cells to the body, and especially the stem cells.

In the meantime, it looks like Andrew will not be back to school full time in the fall, due to possibilities of exposure from other students. He was fine with bringing him at times when Erin felt the general health of his classmates and the school was good. The problem with Andrew going to school full time is that he is more susceptible to viruses that others carry, and that, should he catch something from someone else, it would take him longer to recover. A cold that most people get over in a couple days may take him weeks. This should change as his blood counts continue to rise, and hopefully in the near future they will be high enough to send him back to school full time.

We don't have another visit with the hematologists until August 20, but they will take his blood counts on August 4 and August 11. We will keep you informed when we know what those are.