Thursday Clinic Appointment

Today's clinic appointment started round 4 for Phase IV: Consolidation II.

Her Absolute Phagocyte Count (APC) was actually 8 points too low to start. Her count was at 742 and should be at 750 to start. Since she was so close, her doctor decided to start her on the next round anyway.

The main topic of today's visit was a change in her treatment protocol. Because she has developed an allergy to the PEG aspariginase, they looked into a replacement drug called Erwinia aspariginase which is made in Europe and is not always available. Well, it is currently not available. They have decided that since that drug is not available, they will start her on a drug called Doxorubicin. This drug will replace the PEG aspariginase AND the Methotrexate. This drug is more aggressive than the aspariginase and can become toxic to the heart. Therefore, in conjunction with that drug, she also has to receive a drug called Zinecard which was developed by the army to protect the troops from chemical warfare. This drug will help to protect her heart against the chemical warfare that is saving her life...sounds like an oxymoron to me. Her steroid dose also has been increased from 3 & 1/2 mg per day to 10 mg per day. God help us!!! Her food cravings and mood swings were bad enough before, I can only imagine what this week is going to bring now that her dose has more than doubled.

While we were at the clinic, her port was accessed and she received...
1) a blood draw
2) Vincristine (Chemo)
3) Doxorubicin (Chemo)
4) Zinecard (heart protection)
5) Zofran (to prevent nausea)

She will also be on Dexamethasone (steroids) for 5 days and 6-mercapturine (oral chemo) for 14 days.

This round lasts 3 weeks and consists of the following...
Vincristine - Day 1
Doxorubicin - Day 1
Zinecard - Day 1
6-mercapturine - Days 1-14
Dexamethasone - Days 1-5

This treatment will last for 3, 3 week cycles. Now that she is on a more aggressive treatment arm, she will only have to go to the clinic once every three weeks to receive all of her IV drugs all at once. All of these drugs are administered through her port. So there will not be getting any more shots. She will just have to have her port accessed once every three weeks. Another positive note about the switch in treatment is that she will reach the Maintenance Phase sooner than was originally planned. As long as all goes well, she will now reach maintenance on April 2nd instead of June!!! This, I am very happy about. Although, I am very nervous about how she will react to the higher doses of drugs.

Her next clinic visit is scheduled for Thursday, February 19th.