Tuesday morning, Emily had her first spinal tap procedure. She will have a series of these tests throughout her treatment but this first was an important step for the further classification of her Leukemia.
The spinal fluid is tested to measure the amount of abnormal white blood cells, or Leukemia cells, in the spinal fluid. We have been told that all Leukemia patients will have some amount of Leukemia cells in their spinal fluid and even if it is non-observable, it is important to treat this fluid to prevent relapse later in the life of the patient.
On Thursday, we received the preliminary results of Emily’s spinal tap. The abnormal cells are measured by micro-liter. Low-risk is 0 to 2 observable cells per micro-liter. High risk is 5 or more (the count can rise above 20). Emily’s tests revealed 4 abnormal white blood cells, which places her in the average-risk category for Central Nervous System Leukemia (or CNS-2). It is wonderful news that she is not being considered high-risk (this means the doctors will not recommend radiation therapy), but we would obviously prefer she was low-risk.
The doctors are sending the spinal fluid out for further testing that will provide a much more accurate count of the abnormal cells. Emily has had very positive results in all other areas and this is the first abnormal result they have seen, therefore they want to double check their findings before proceeding with a firm diagnosis. It is possible the higher count of white blood cells was due to other conditions (such as infections) or that the micro-liter of fluid they tested had an abnormally high count and testing a larger quantity of the fluid will give a more precise result.
No matter the result of the further testing, Emily will continue to receive some chemotherapy treatments directly to her spinal fluids. The classification between CNS-1 and CNS-2 will simply determine the intensification of her treatment and overall length of treatment (estimated at this time to be 2 and a half years).
Please pray for the doctors responsible for further testing, that they would have skill and insight to accurately make an assessment of Emily’s case and be able to use the information they gather to make the best decisions for her treatment.