Normal white blood cell counts range from 4500 to 13500. Throughout therapy Jemma's leukocytes have ranged between 0 and 4000 with the vast majority of the time spent below 2000. When the count fell below 500 she was at serious risk for infection both from people and her own body. The goal of the maintenance phase of therapy is to give her medication in a dose which will allow her to maintain a white blood cell count in the 2000 to 3000 range. The 2000 to 3000 range gives her some immune system protection while keeping the count low so that the Leukemia cells don't have time to reproduce.
Results from her blood test today showed her current level to be 800. Since the leukocyte level was so low, we need to return to the hospital on Friday for another blood test. The removal of her catheter will probably be delayed until her blood has recovered, and if the leukocytes are still falling she won't be allowed to be around other children. In other words - no dance this week.
During the intensive phase 1B of her therapy Jemma also received PuriNetol. The phase was scheduled to last 4 weeks, but Jemma's blood had a very difficult time recovering and 1B actually took 2 months to complete. During phase 2B she received Thioguanine which is a similar medication. 2B also lasted twice as long as the scheduled time.
This all sounds so bad, but Jemma really feels good. Before going to the hospital today I was sure her blood test would show improvements. It's very strange getting results that say her blood is not good when I see her running and playing.