It's official, Ann's new stem cells have engrafted! She has maintained a Absolute Neutrophil Count (ANC) above 0.5 K/uL for the last three days, and her WBC count has continued to climb. Today it's at 1.6 K/uL. Thats not normal yet, but it's continually improving.
On a side note my mathematical model turned out to be wrong. Not by much but still wrong. My prediction had Ann's WBC count reaching 1.0 K.uL on the 20th. Also I estimated the cell doubling time to be around 13 hours. Turns out it is closer to 10 hours. Oh well live and learn.
The Doctor who visited us this morning told us that we should get ready to leave the hospital for our apartment Wednesday. Ann is excited to be leaving, and to be having the transplant going so well. As was pointed out by the doctor again, she is the star of the transplant floor. They where really expecting her to have a much rougher ride than she has.
All I can say is hurray! I hope that this proves that expanded cord blood is a good idea and it opens this treatment up to lots of other patients that need stem cell/bone marrow transplants who can't find a matching donor. Personally I believe that this is something that should be considered as a standard of care for patients who are out of options. I have told this to my representatives in the U.S. House and Senate. I hope they were serious when they said they would act on it, because a lot of Americans just like Ann have died waiting for their second chance.
The question of "where things go from here?" has been raised so I want to take a moment to address it. About 60% of all transplant related mortalities occur in the first 100 days after transplant. These are from infections, GvHD (Graft vs. Host Disease), relapse, or miscellaneous complications. So patients in the first 100 days here at MDA are watched very closely. Each and every day they have to report to the clinic building early int he morning and spend almost the entire day in isolation, getting IV fluids, antibiotics, and other medicines. Then they are allowed to go "home" and sleep in their beds before coming back again in the morning.
We are only on day +19 and have another 81 days to go before we are out of the 100 days. So I'm definitely of two minds when it comes to Ann being released. part of me is excited and happy and the other is terrified that something might happen and I won't be able to get her back to the hospital in time. After speaking with the nurses it turns out that this is actually pretty common. Lots of patients and caregivers (I fecking* hate that word ) suddenly turn up "sick" just before they are due to get out [*Father Ted ref]. Of course this subterfuge is pretty transparent to the people who have access to the results of daily blood tests.
Ann doesn't have any of these reservations and is more than ready to get out of here. I really hope that the next 81 days go as well as the last 19.