Ethan’s Course of Treatment

» Posted by on Feb 15, 2012 in Updates | 7 comments

Now that we have an idea of Ethan’s response to treatment it becomes easier to predict the full course of his care. For rapid early responders with high risk ALL, they break down the treatment down like this:

  • Induction (4 weeks): 95% of kids achieve remission by the end of induction.Drugs used: prednisone, vincristine, daunomycin, PEG-asparaginase, cytarabine, methotrexate.
  • Consolidation (9 weeks): cyclophosphamide, 6-mercaptopurine, cytarabine, vincristine, PEG-asparaginase, methotrexate.
  • Interim Maintenance (8 weeks): methotrexate, vincristine, PEG-asparaginase, methotrexate.
  • Delayed Intesification #1 (4 weeks): dexamethasone, vincristine, doxorubicin, PEG-asparaginase, methotrexate.
  • Delayed Instesification #2 (4 weeks): cyclophosphamide, 6-thioguanine, cytarabine, PEG-asparaginase, vincristine.
  • Long Term Maintenance (2.5 years): vincristine, prednisone, 6-mercaptopurine, methotrexate.

Each drug listed is administered on a very specific schedule. Some of them are daily, some of them are weekly, some of them are given on day 29 or day 42, or when the harvest moon collides with orion (just kidding). They are also given differently: orally, port injection or injected in the spinal fluid. It’s common for there to be times when patients have to stop or delay a phase of chemotherapy in order to deal with fever, infection, very low blood counts, drug reactions and etc. It’s also possible they could bump us into a lower risk category with a different treatment plan or a higher risk category which could include radiation or stem cell transplant. I took the time to write out the entire treatment on a calendar. Our best case scenario is to be starting Long Term Maintenance at the beginning of August.

I gave Ethan a hair cut today because he was looking rather shaggy. Some people have been wondering when he will start to lose his hair. I’ve been reading other family’s experiences with this particular type of treatment and it seems that most of them begin to lose it at the end of induction. We’ve talked a little bit about it and he doesn’t seem to be very worried. I’m just glad that chemo doesn’t change eye color because there is nothing I love better than those blueberry blues!

What we are praising God for today:

  • Ethan is technically now in remission! His bone marrow blast count was reduced from 50% to 1% in only 8 days of treatment. His peripheral (blood) blast count was reduced from 65% to zero in only 6 days of treatment.
  • Overall his body is handling the chemo very, very well. We are managing to get through most days without the aid of Zofran for nausea. He hasn’t had to take any pain medication since beginning treatment.
  • His appetite is great! He is gaining weight right now and craving lots of protein and savory carbs. His sweet taste buds seem to be on vacation.
  • His hematocrit and platelet counts are stable.

What we are praying for today:

  • Ethan’s blood ANC (a measure of natural immune function) is starting to drop. On Monday it was 324. The threshold for being in groups or going out in public is 500. We are praying for higher ANC counts on Thursday so Ethan is better able to fight off infection.
  • On March 1st Ethan will have another bone marrow biopsy. At that time they will be doing a highly sensitive screening to measure MRD (Minimal residual disease). This is the most accurate way to test how much cancer is left, down to as low as 1 cancer cell in a million. This test is the big kahuna. We want MRD < 1% and we believe that with God’s healing touch it can even be ZERO.
  • Protection from infection and fever. More than half of ALL kids return to the hospital within the first month for fever.
  • Ethan has a high risk form of ALL. This particular type is more resistant to treatment and more likely to relapse. We are praying that the chemo treatments would be extremely effective and that the cancer cells would stay gone so that Ethan’s story will be a great testament to the healing power of Jesus.


  1. Ethan, so happy that you have responded so well! So many people are sending thoughts of good health and remission! I know you can do this! I know you can!

  2. Looking good! Like the haircut.

  3. Thank you for the update, the praise, and the prayer requests. God Bless You!

  4. your the most handsome guy ,what a hot hair do. miss you very much ,hope tosee you soon. love miss carole

  5. God bless you and your family!

  6. Ethan I am so happy you are responding to treatment and have a good appetite. You will always be in my prayers.

    Love, Aunt Marti ox

  7. Hi Ethan, Keep on letting ‘The Force’ be with you. Glad you are responding well and keeping you close in prayer. Love you.

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