2005 Journal Entries

Leukemia is cancer of the blood-forming tissues that make up the bone marrow inside large bones. When a person has leukemia, the diseased bone marrow floods the body with abnormal white cells, or blasts. These cells do not perform the infection-fighting functions of healthy, mature white cells. Additionally, production of red blood cells, which carry oxygen, and platelets, which help prevent bleeding, is decreased.

When we rushed Archie to the hospital two Monday nights ago, he had over 110,000 white blood cells pumping through his veins. Approximately 88 percent of his cells were blasts, or diseased cells. Today Archie’s white blood cell count is slowly rising to normal range, and he has no blast cells in his blood. I don’t think Archie has ever lived a day before today when he had no blast cells in his blood.

But Archie continues to be a maverick and mystify the medical world. Today’s CBC reported that Archie has over 3 million platelets in his blood. If Archie were any other child recovering from a round of chemotherapy he would have probably already received two or three platelet transfusions to boost his own count. But he hasn’t received any platelet transfusions. These 3 million cells are all his own.

Dr. Stroud has consulted his colleagues in the Children’s Oncology Group, an international research group that consists of more than 200 hospitals in the United States, Canada, Australia and Switzerland that conducts research to learn about the causes of cancer and how to prevent and treat children with cancer. Dr. Stroud can’t explain the excess of platelets in Archie’s blood and neither can any of his colleagues. The author of the treatment protocol in which Archie is enrolled, “The Treatment of Down Syndrome Children with Acute Myeloid Leukemia and Myelodysplastic Syndrome under the Age of 4 Years,” can’t explain these results either. He’s never seen such a thing before.

So this morning Dr. Stroud performed another bone marrow aspiration in attempt to explain Archie’s very high platelet count. He sent portions of Archie’s bone marrow to the Mayo Clinic for cytogenetic studies to determine if there’s any chromosomal abnormality present in Archie’s DNA other than Trisomy 21 that could explain Archie’s leukemia. We’ll know the results of those studies next week. This afternoon, though, we knew the results of Archie’s flow cytometry and aspiration. Both samples are free of leukemia cells. The results of the bone marrow biopsy will be returned tomorrow and Dr. Stroud is fairly confident that study will be clean of diseased cells, too.

“We couldn’t have asked the chemotherapy to do anything more than it did,” Dr. Stroud explained to me. I may be wrong, but I think I detected a slight hint of giddiness in his voice. “But I still have no idea where all the platelets are coming from.”

These past few days Archie has been pleasant, and charming, and an absolutely joy to be around. He doesn’t grump, or complain, or fuss. He eats what he’s offered, even food he’s never accepted before. And Archie doesn’t pitch a fit anymore when the nurses and doctors enter his room. Instead he waves them into the room and performs for them. I haven’t seen this side of my son for months.

Admittedly, I feel cautiously giddy, too.