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After yesterday's good news that James's bone marrow has been given the all clear, we had an appointment with the Prof who is in charge of James's treatment where we were able to hear more fully about the bone marrow test and analysis. We appreciated that both Prof and James's pediatrician seem to understand how difficult this is for parents emotionally!

He explained to us that although chemotherapy for children with ALL (the kind of leukemia James has), the main remaining problem is that even after years of treatment, some still relapse... this is because even after the treatment, some residual diseased cells can still remain, which can then multiply... a lot of research is currently going into trying to distinguish these cells before a relapse occurs, but this has not yet been successful.

So when they saw these strange cells in James's bone marrow they wanted to check as much as possible to see if there was any evidence that they could be diseased. They consulted with colleagues at Red Cross Hospital as well (they see a lot more paediatric cases), and concluded that the evidence all points towards them being normal cells. Importantly, they look different to the original leukemic cells that James had, and they show no signs of abnormality.

So the conclusion is that James is doing as well as he possibly could be under the circumstances. The risk of relapse remains, and the next expected high risk period is when he finishes his maintenance chemo in just over 18 months time... it was a bit disconcerting discussing this possibility again, but that's the reality!

We also discussed James's liver - his liver enzymes keep on fluctuating; while they aren't at a dangerous level, they're not going to increase his methotrexate dose unless they normalise more. This explains why James seems to not want food at some times but not others.

We are so grateful to God for sustaining us through the past few weeks, and we're trying to take a deep breath to gather our strength for the reality of the road ahead. Next week we're going away for a long weekend which we're really looking forward to!


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