Intensified Consolidation

OK, sorry for not posting much lately. I've been trying to focus on work and Nicole has been spending lots of time at the Infusion Center with Ben (and dealing with bugs in the house and a broken air conditioner!). Anyway, here are some details on the next stage of treatment.

First, a little overview. There are five phases to Ben's chemotherapy. In chronological order, they are Induction, Consolidation, Interim Maintenance (IM), Delayed Intensification (DI) and Maintenance. We just finished Induction and are now in the Consolidation phase. The study we are participating in breaks the kids down into four groups based on the treatment they'll get during the middle three phases. Group I is getting standard treatment throughout. Group II is getting intensified Consolidation and standard IM and DI (Ben is in this group). Group III is getting standard Consolidation and augmented IM and DI. Group IV gets intensified Consolidation and augmented IM and DI. (Don't ask me the difference between "intensified" and "augmented." Both mean "more"! :)) The idea is to determine whether more treatment at the different stages results in a better overall prognosis.

One thing we sort of glossed over before: we are not at all out of the woods yet. You see, while the remission rate is better than 90% when the kids first get treated, the leukemia comes back after a while in a lot of the kids (less than 50%, but still a lot of the kids). The remission rates during the second treatment are not nearly as high. So this study is not just about getting the 90% rate up, but also getting the reoccurrences down. The doctors really have no idea which of the four protocols is best, but Ben would have received either Group II or Group III (or some hybrid of the two) had we not done the study.

OK, so here is what Ben will get during Intensified Consolidation:

Cyclophosphamide (via PICC line), Days 1 and 29.
http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682080.html

Cytarabine (via PICC line), Days 1-4, 8-11, 29-32 and 36-39.
http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682222.html

Mercaptopurine (by pill), Days 1-14 and 29-42.
http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682653.html

Vincristine (via PICC line), Days 15, 22, 43 and 50.
http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682822.html

PEG Asparaginase (these are the giant shots in the thighs), Days 15 and 43.
http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a695031.html

Methotrexate (via spinal tap), Days 1, 8 and 15.
http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682019.html

He also is getting lots of drugs to control side effects, like antinausea drugs.

The cyclophosphamide (aka Cytoxan) has been interesting. It is a mustard gas derivative (!) which is really hard on the kidneys. So Ben has to spend a long time in the Infusion Center to get it -- they hydrate him for a few hours, then give him the drug, then hydrate him again and test his urine to make sure he's OK before they send him home.

It is no fun getting all of this treatment, and we could not be prouder of Ben. The treatment is made much easier by his PSP, the Fun Centers provided by the Starlight Foundation, the playroom and the Child Life Services staff at Cedars. So later on I'm going to hit all of you up for donations again. The ones to pick for these purposes are the Starlight Foundation and the Cedars Pediatric Hematology-Oncology Fund -- links in the right margin. I'll post pictures and stuff in a later post to try to soften you all up, but I think this is enough typing for now.

Thanks again to everyone for your continued good thoughts, prayers and support.