Well, LTM is delayed because Mollie's ANC is below the cutoff. By machine, her ANC was 11oo, but the manual count revealed that it was 650; the cutoff is 750. Her platelets and RBCs are in the normal range. The 10 days of antibiotics might have suppressed her ANC somewhat, or her bone marrow may just need a little more time to recover from DI.

So, we wait a week. Just a bump in the road, and a chance for Mollie to get a little stronger before starting more chemo. Mollie didn't even cry for her finger stick and she hardly complained about being NPO. In fact, when we got into the exam room she asked me to close the door so she couldn't see the snack area (it would make her too hungry).

We met a little girl named Molly today in the clinic. She was diagnosed with ALL a few weeks ago and was in the hospital at the same time as Mollie (before Christmas). She's just two years old and is going through the really intense chemo & steroids of Induction. Her parents have that "deer in the headlights" look that I'm sure we had too for a month or so after Mollie was diagnosed. I hope they ask us if they need help with anything- networking with other parents of cancer kids was one of the most helpful things for me.


  1. S, offer your support to them. sometimes it is hard to ask for help.

  2. S, can you explain more about the difference between ANC of 1100 vs how the manual count comes up with just over half that?

    Oh my goodness- TWO years old?!! I know it happens, but that's just so little! I hope you're able to help them plenty. Maybe some sort of small gift (ribbons to tie you together... I like cheesy puns when they have good meaning :) would help to break the ice?

  3. The machine measurement is done on an automated cell counter that evaluated the cell types (white blood cells (WBC), platelets, red cells) based on their size, shape, and electrical properties. However, if the blood sample contains cell fragments and platelet clumps, the machine can't distinguish them from WBCs and it reports a falsely high WBC (and ANC). For the manual count, a human actually looks at a blood smear under a microscope. It is more accurate (and time consuming).

    I did offer Molly's family our support and we will see them next Tuesday so hopefully I can talk with them a little more.


Comments are always welcome!