Zoe’s WBC count hit 6.8 this morning, up 1.3 from yesterday. Just amazing. No ANC yet, we aren’t getting daily differentials right now that she has entered normal cell range. I have been waiting for it to go down some, we’ve been warned repeatedly that it tends to go up and down, but so far she’s just building.
At the moment Zoe’s only real symptoms/side effects are the continuing mucus discharge (spitting up as she heals), pain twice a day when receiving the cell growth factor medication, and some pain around her bum breakdowns. All in all, we’re making progress in that she’s not having as much daily bone pain, nor does she have any more sores in her mouth.
As mentioned yesterday, there is a possibility we’ll be discharged in the near future. I’ve been asking around a bit about that, and it seems they look for good progress on counts — engraftment, no infections, and for the parents to be “ready” to handle the care.
When we first were in discussions to get Zoe into Duke and planning her transplant, one of the things that came up was that the fastest anyone had ever been discharged from the Pediatric Blood and Marrow Transplant wing is +23 days. At that time, being the guy I am, I thought, “Zoe can beat that!”.
Now, I have no interest in that. All I care about is making sure she is at optimum health before we’re released, and that we all know exactly how to handle things. The next few months will be stressful while we wait to make sure her graft holds and she is clear of GVHD.
On Monday they will do her Chimera test, which is a method of determining what percentage of cells are her old immune system, and what percentage are the new. We want to see mostly new cells. I have been cautioned that patients can get by with far fewer than 100%, as little as 20% donor cells, and live normally, but again we are hopeful for something north of 50% for this first test, the closer to 100% the better. We’ll get results back on that later in the week, it will be a big news day when we know.