Dr. Vusirikala explained this morning (April 1st) that test results show 76% of all the white blood cells in Rachana’s blood are blast cells or leukemia cells. The goal in these 4 weeks in to get that to 0% i.e. to get her into remission. Chemo is the way to do that, but chemo will basically kill everything in the bone marrow. It’s crazy how many pills, IVs, blood, platelets, etc., Rachana is given in response to the chemo. Whatever little good RBC, WBC and Platelets that Rachana’s marrow was producing, that will drop further as the chemo kills everything in the bone marrow.
- Without RBC her organs are not getting oxygen and the body is slowly shutting down – to counter this she will be given blood (RBCs).
- Without WBC she cannot fight infections – to counter this she is kept in a sterile environment. Even the harmless bacteria that is on everyone’s skin can become an issue, so she has to be at DEFCON-1 to protect her body. She has to take a bath daily and brush multiple times a day. Without enough blood she is very tired and these simple tasks are a battle. Anyone slightly sick or who have taken a antibiotic in the last 48 hrs cannot see her. One of the nurse told us told us that a caregiver in another room was coughing and was sent home. They are already giving Rachana some 6-8 pills to keep a host of illnesses at bay + a few for other reactions + some for nausea
- Without platelets her body cannot heal a cut. So every time they do a procedure they have to give her a few units of platelets for the body to be ready to heal. Even without procedures the body needs platelets.
The blood and platelets transfusions are to keep her going – and since this blood is not her own it does not stay in her body for long and therefore she will be given blood 1-2 times a week. Platelets are given as needed as sometimes the body generates anti-bodies to fight these foreign platelets and so they have to monitor that and give other medication to kill these anti-bodies. WBC transfusions will be given in an emergency if she has any infection that cannot be controlled.
There was some additional information and clarification on Bone Marrow Transplant (BMT). In 3-4 weeks we’ll get mutation analysis, which will determine if BMT is required. It seems even if BMT is required, you have to be in remission (0% cancer) for it to work. Rachana’s siblings are getting HLA testing done to see if they can be potential donors if BMT is required. Siblings are the first choice before they go to a BM registry for potential matches.
So almost everything that’s happening here in the hospital is to manage the side effects of chemo – because it’s killing everything and not just the bad guys. I hope they develop a Smart Chemo that does not carpet bomb the body and targets only the bad cells. I’m sure a bunch of them are already working on it and cancer will some day be treated like flu.