Today we start Fludarabine, which is Zoe’s 2nd major chemotherapy medicine in the Reduced Intensity Conditioning (RIC) regimen. Fludarabine is designed to eliminate fast growing cells, any fast growing cells. Cells in the bone marrow are very fast growing so they are what will be most affected. Campath is a drug that specifically targeted Lymphocytes (virus fighting cells that are part of any normal immune system), whereas the Fludarabine will eliminate everything in the marrow. It may also finish off the last of her hair, but Maya was nearly bald until she was a year old, so we’re used to that.

It’s considered a well-tolerated medication, so we are hopeful that we won’t see anything at all this week, other than a drop in cell counts and perhaps some fatigue. So far that’s been the case.

Zoe’s counts came back up a bit over the weekend:

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  • WBC: 2.9
  • Hemo: 9.5
  • RBC: 3.12
  • Platelets: 730
  • Lymphocytes: 3%


We’ll continue Fludarabine until Friday. Also on Friday Zoe will get an additional Central Line placed, which means surgery. Hopefully the last major one.

We’ll be admitted to 5200, the Pediatric Blood and Marrow Transplant ward on Friday after surgery, and we will then begin the last medications before the transplant itself next Wednesday.

Zoe is handling all of this as well or better than we are. She’s a fantastic baby.