Start of Consolidation Phase

Today we the started of the second phase of treatment.  Karlee finished the Induction protocol last week and this morning we were back at the hospital to find out what the plan would be for the next 5 months of treatment.  The morning was a little crazy with trying to get Karlee and Ryley ready to be out the door by 8am.  We dropped Ryley off at the neighbors to take him to school and headed up to the hospital with Karlee.  About 3/4 of the way up there we realized that we had forgotten the Ametop (numbing cream for her port access).  There was nothing we could do at that point except get some on when we go there and wait for it to work before they could access her.


When we got up there Karlee had gained another 0.6 kg (a little over a pound).  She should start to lose weight shortly as her water retention starts to drop with the discontinuation of the steroids for a while.  We got to see Dr. Singh right away without any wait (very nice).  He went through the 3 different criteria that are used to determine the rest of the treatment and how favourable her results were on all 3.

1. She was a very rapid responder as she was down to less than 1% of cells being blast cells within the first week.
2. Her genetic testing had a very favourable translocation in her chromosomal analysis.
3. Her leukemia is undetectable using the most advanced testing they have available.  They are able to detect blast cells at levels of 1 in 10,000 cells and they could not detect any in her bone marrow.

This resulted in her being moved to the lowest risk level and determined her course of treatment for the next 5 months.  The next phase is going to be one month in length and is called Consolidation.  She will then move into 2 months of Interim Maintenance followed by 2 months of Delayed Intensification.

The Consolidation Phase involves various types of Chemotherapy.  Today she got one dose of Vincristine and a spinal injection of Methotrexate.  She also started on her first oral chemotherapy today.  She is getting 1mL daily of 6-mercaptopurine (6MP) for the next 28 days.  Over the next 2 Tuesday's she only gets the spinal injection of Methotrexate.

Today we realized how fortunate we are to have such a cooperative little girl.  While we were in there today there were 2 little girls, one a little older than Karlee and one a little younger.  Both screamed and fussed while they were getting their ports accessed.  Karlee on the other hand helps the nurse and enjoys counting the cleaning and the actual poke.  We were out of the hospital just after 1 today and were home in time for Mom to do her afternoon run and for Dad and Karlee to pick up Ryley.

This evening was the first real Beaver activity of the year with a trip to the Calgary Corn Maze.  Ryley and Dad had a great time getting lost in the big maze, bouncing on the giant pillows and painting their fingers in one of the little mazes.  They have a petting zoo there and they had a brand new baby goat that had been born in within the last 3 hours.

There are a few interesting little things that most people probably don't realize.

• For 48 hours after Karlee receives chemotherapy we have to use gloves to wipe her when she goes to the washroom.  This is due to the toxins that are being expelled from her body.
• When Karlee receives chemotherapy in the hospital the nurses have to wear a full blue gown, heavy duty gloves and goggles.  This is to protect them from repeated exposure to chemotherapy.
• Karlee removes her own bandage when they deaccessing her port.  She unpeels the large clear bandage and pulls off the tape so all the nurse has to do is remove the needle.