3-12-09: Dasatinib Treatment Fails

Sarah has returned to the hospital today. The visiting nurse came to our house Wednesday to draw Sarah's blood for CBC. Sarah had 45% blast count in her blood (45% of the white blood cells where leukemic). Sarah's blast count was 73% when she got to the hospital today for chemotherapy. The doctors don't think the Dasatinib was working for her. I guess we'd have to agree.

The plan as of last Saturday was to have Sarah return mid-week for additional chemotherapy. We just didn't plan on doing it with a high blast count. The chemotherapy she is getting is high dose methotrexate. It's administered over 24 hours. We are praying she tolerates the treatment as well as she has previous chemo treatments and that the blasts do not return when her blood counts begin to rise again.

We talked with the bone marrow director at Dana Farber tonight to see what she'd require for Sarah to move into DLI treatment. The DLI might buy some time for Sarah to prep for a 2nd BMT. Basically, Sarah needs get to <10% class="blsp-spelling-error" id="SPELLING_ERROR_7">DLI at Dana Farber. The BMT director also mentioned 2 clinical trials Sarah might qualify for, one ongoing in Washington and another at Dana Farber in about 1 month. We'll be discussing the clinical trials with Sarah's oncology team tomorrow. One additional option we will be considering is another new targeted drug called Nilotinib. It's similar to Imatinib and Dasatinib, but each one can have a greater or lesser impact on specific mutations of Sarah's type of cancer.

Three of our children are staying with another family we are friends with. The rest of our children are with us at the hospital. We are staying at Davids House which provides housing, food, laundry, etc. for families of children in the hospital. Davids House is one parking lot away from the hospital.

We know Sarah's treatment options are dwindling. It's not a good feeling. It took a bit of searching to renew our hope, but God is continuing to provide that for us. We'll continue to pray and listen and hopefully hear what God is asking for us to do next.
-Ben

Sarah has been doing pretty well since she came home. Her nausea seems controlled and the diarrhea is becoming less frequent. The weekend was pleasant. Yesterday we took full advantage of the sun and warmer temps and went to the park. Sarah had a great time and played and laughed like a normal 4 year old until she had some diarrhea and we had to leave because we didn't think ahead enough to bring her extra clothes.

The visiting nurse came this morning and drew Sarah's blood. All counts looked pretty good but she did have an increase in her blasts. The blast count went from 1% to 2%. Not a big increase but it did double. We are currently doubling her Dasatinib from 40mg to 80mg per day.

Sarah's VNA will be back on Weds to draw more labs.

Please pray that those blasts will go back down to 0% and that Sarah will tolerate the increased Dasatinib well.

Please also pray for Sarah's friend Cameron who is also battling Leukemia. Cameron is in the hospital today because of a fever and neutropenia. He is also starting the radiation part of his treatment (which can be scary because of the need to be restrained in a mask that gets screwed down !) Please pray for him to have relief from anxiety and for his fever to turn out to be nothing.