Finally, after a lot of anxiety, prayers, tears and scheduling nightmares, William was admitted into the City of Hope yesterday. William was scheduled to start his chemotherapy last night however, all of the fun we had over the weekend left him a little dehydrated so we spent the night hydrating him and started chemotherapy this morning.
There is so much to tell you about the City of Hope... Where do I begin? I am so exhausted that I don't think I actually have the energy to write about the facility - I will ask my mom to write a more details entry tomorrow and to include details about the hospital and staff.
I have received a lot of emails and calls asking questions about the upcoming Stem Cell Rescue and the Bone Marrow Transplant. (BMT) The following is an explanation of both....
Medical Talk 101 -as with most things related to cancer, momcologists get most of the information from each other; therefore, the following information is all from another Momcologists blogs. Her son recently went through stem cell rescue and a successfully bone marrow transplant.
WHY IS A BONE MARROW TRANSPLANT NEEDED?
A transplant will be needed because the very intense chemo in this phase of treatment will destroy his bone marrow and hopefully any residual cancer that the chemo did not get.
HOW ARE STEM CELLS RESCUED AND HARVESTED?
After William has completed this round of chemotherapy, he will get daily Neupogen injections to push his stem cells out of his bone marrow and into his blood so they can be collected.
Once William's body is ready give us what we need, a double catheter will be put into a large vein in his groin, and blood will be taken out and the various components of the blood will be separated by density in a centrifuge. The stem cells will be taken and frozen for use in the transplant and the rest of the blood will be put back in through the catheter. The procedure is done under local anesthesia and should take 4-5 hours. Most of the time they're able to get enough stem cells the first day, but it is possible he'll need to have more cells collected during a second round. PLEASE Pray that we only need to do this once!!!
BONE MARROW TRANSPLANT, HOW IT WORKS:
Once William is done with his high dose chemotherapy, his bone marrow willl be non existent. Basically, if you were to look inside the bones, they would be empty (picture a dead sea sponge),all of the marrow substance is gone, dead. At this time the stem cells that were harvested are now transplanted back into the body and find their way back to the marrow space to engraft into the bone and start reproducing themselves and eventually produce daughter cells (the white and red blood cells, platelets, etc.). Oh, and the stem cells are specifically bone marrow stem cells and they have receptors so when the blood passes through the bone marrow space, the specific stem cells know to attach to the bone while the rest of the blood cells and particles continue right on through. Isn't that amazing?
WHAT IS ENGRAFTMENT?
It means the stem cells found their way back to the marrow space, attached themselves to the bone and replicated themselves enough to fill the space and then start to produce the daughter cells (white and red blood cells, platelets). Think of it like a factory (the bone marrow space). You have to spend time hiring employees (stem cells) to fill the factory. When you have enough employees you can start production on your product list (white and red blood cells, platelets). Over time, the employees become stronger and more efficient and can more easily negotiate production malfunctions (need for transfusions, infections).
Please pray that William's body is strong enough to give us enough Stem Cells! Please pray that one one harvest procedure is necessary! Please pray that God continues to heal my little boy's body.. Please pray for all of the other DSRCT patients!
Keep on Keepin on.
Live Strong in God's promise to answer our prayers.
Yesterday, William had a PET scan done at City of Hope. Shortly after the scan was completely my mom, William and I met with Dr. Anderson. Now, before I get into the preliminary results from the scan, let me explain how it works. In a PET scan, William is given a nuclear sugar mixture that the cancer cells absorb. The uptake amount of the nuclear mixture into the cells are measured in the densities or brightness levels that appear on the scans. Normal cells have an SUV (standard uptake value) of around 1 to 2. Cancerous cells are higher and are normally around a SUV of 5. The more uptake a cell has, the brighter it shines on the PET. So basically, an active, thriving and living cancer cell eats a lot of the nuclear mixture and therefore appears as a bright spot on the scan. If a cell has an SUV of around 2 to 4 then the brightness of the cancer is not as apparent. 
Christmas Tree" as he did in February of this year. 
I cannot tell you how happy we all were to hear the news! Even though William does still have a few bright bright spots, they are significantly less than they were! The spleen, pelvic lymph node, and one large tumor in the liver were the only bright spots ;)
becomes chemo resistant, it was time for us to start on our path down aggressive treatments. On 
Monday, William will start 5 days of Ifosphomide and VP16 with a bladder protection Rx, Mesna. William's extreme bladder damage caused by the first two rounds of chemo (P6) in April of 2010 forces us to be careful with the types of chemo used, however we also need to be aggressive enough to shock and kill the remaining caner. Dr. Anderson is working with his colleagues to determine the best dosage for William. 
the Long Beach house for approximate 10-14 days. During that time William will receive daily Neupogen 
injections to stimulate the growth of white blood cells. Around day 10, we will return to the hospital for daily blood draws. Like fertility tests, there is a "magic hour" or a window of opportunity during which William's body will have produced enough stem cells for the doctors to go in and "rescue" them so that they can be used in his bone marrow transplant. 
Step 7. BONE MARROW TRANSPLANT! 
As you can imagine there will be plenty of other medical procedures and events happening after the BMT is done. = Whole liver radiation and surgery is obviously going to be a big part of treatment but, for now our road map for the next 3 months is set in stone!
