4:00 PM (Randall posting): I just got off the phone with the clinic and Sophie's counts are all looking good. Her ANC count is 0.7 (or 700, depending on which scale you're used to). This means that her immune system is definitely becoming compromised. In fact, she's right at the borderline where we need to begin taking precautions about exposure to infections. She's also right at the cut-off for a pause in the treatment, but we'll go ahead and do the chemotherapy tomorrow (methotrexate and vincristine through her IV and methotrexate through a spinal tap--because Friday is not a normal sedation day at the clinic, Sophie will be treated with "conscious sedation" rather than the usual "Milk of Amnesia.")
In this particular phase of treatment, Sophie is supposed to be receiving increasing doses of methotrexate, but since she is approaching toxicity, she will only receive the same dose she received last week. In some ways we are grateful to have her counts where they are at, rather than have them drop really, really low sometime between clinic visits and be unaware of how weak her immune system has become. Some kids develop painful mouth sores and the like during this phase, which are simply (!) another indicator of toxicity, but Sophie hasn't developed any such signs yet.
We have another week and a half of this phase in the protocol, so we have a ways to go yet. Please remember to keep us all in your thoughts and your prayers as we continue this patient walk through the protocol.