We spoke to Jeremy’s doctors today about the results of the bone marrow aspirate.  We’ve all been praying hard for Jeremy to be placed in the low risk category.  Sadly, we found out today that Jeremy is high risk.

We got a lot of information in that meeting, so I’l try to break it down as best I can.  Here are some terms we heard today that explain Jeremy’s current status: MRD (minimum residual disease), CNS (central nervous system), CSF (cerebral spinal fluid), blasts (leukemia cells), BMT (bone marrow transplant).

First, praise God, Jeremy is CNS negative, meaning that there are no leukemia cells present in his CSF.  This is good news.

Secondly, praise God, Jeremy’s aspirate results showed that there are less than 5% blasts in his bone marrow.  This is a good thing, as it means he responded well to the chemotherapy.  In a person without leukemia, doctors would expect the same thing.

The MRD test was one of the markers that would determine Jeremy’s risk category.  Jeremy’s MRD test showed that he is MRD positive, meaning he does still have leukemia cells floating around.  They quantified it for us – an MRD result of 0.1% is considered low risk.  Jeremy’s MRD was at 0.5%, placing him at high risk.

What does high risk mean? Basically, it means two things.  A treatment change and, very likely, a bone marrow transplant.

In regards to medication – if he were low risk, this round of treatment would have looked like the last one – same medications – cytarabine, daunorubicin, and etoposide, same dosage.  Because he is high risk, he will be on a slightly different combination of medications at a higher dose – cytarabine and mitoxantrone.  The mitoxantrone is a new medication and it comes with its own set of side effects – the more serious being damage to his heart.

In regards to the bone marrow transplant, we will be talking to a team tomorrow to initiate a bone marrow match donor search.  A bone marrow transplant path means that he will have a round of intense chemotherapy to wipe out his bone marrow, followed by rescue via transplant.  I’m not entirely sure of the details, but I will document it when we find out more.  It is not the route we wanted to go, but we are confident that God continues to use this situation for His glory.

Praise God:

  • that Jeremy is CNS negative
  • that the blasts in Jeremy’s bone marrow are less than 5%
  • that Jeremy remains in high spirits

Please continue to pray:

  • that God would continue to use this situation for His glory
  • that we would be obedient to God’s plans for this situation
  • that we would continue to cast our worries and fears on the Lord
  • that God would provide full and complete healing and total health for Jeremy
  • that God would sustain Jeremy through this block of treatment
  • that God would give Jeremy an extra portion of His strength for this block of treatment
  • that Jeremy would not encounter any life threatening side effects
  • that Jeremy would not have any brain, liver, lung, kidney, pancreatic, heart, or any other type of organ damage as a result of the chemo
  • that Jeremy would not encounter any fevers due to bacterial, fungal, or yeast infections
  • that a suitable bone marrow match would be found for Jeremy
  • that Alice and I would not get sick in order to care for Jeremy