Update 1/22/10

We met with the bone marrow transplant team this afternoon. Following the first 3 induction cycles of chemotherapy will be 3 consolidation cycles where they will hit her with a combination of even stronger cancer fighting chemotherapies that unfortunately will eliminate Talitha's bone marrow. To rescue her during these consolidation cycles, they will give her infusions of her own stem cells harvested after the second induction cycle.

Assuming this first induction cycle is no more than 1 month, we expect that her second induction cycle will begin around the middle of February with a full week in the hospital like this time. Then they will test her white blood cell count on a daily basis looking for a peak recovery day when the stem cell production is at its highest. At that point they will do another surgury to insert another double lumen catheter--this one in her groin area--through which they will pull her blood into a specialized machine that will strip off the white blood cells and then re-insert her blood into her body.

They will need to harvest 15 million stem cells per kilo of weight. (Talitha is about 11 kilos so they will need to get about 165 million stem cells.) The stem cells make up about 1% of the white blood cells during peak production so you can do the math on approximately how many white blood cells will need to be harvested during the operation. If they don't get enough on day one during the 4 hour procedure, they will harvest again the following day.

During each of the 3 consolidation cycles, they plan to use 5 million of her own stem cells per kilo (approximately 55 million each cycle) to rescue her / rebuild her bone marrow. The bone marrow transplant team was very positive about this procedure and indicated that little children tend to respond very well and are left without bone marrow for only about 5 days before the rescue cells rebuild it. During these consolidation cycles, they've indicated Talitha will be in the hospital for at least 3 weeks each cycle. (gulp)

I've sure I've way oversimplified everything but at least that's the picture we now see at the 100 thousand foot level.

Talitha loves to go on walks/stroller/wagon rides around the ICS. She's adorable and is trying her best to put up with the interminable nonsense of fussing nurses, stressed parents, and loss of appetite.

She wants everyone to know how much she loves you and how grateful she is for your prayers and faith on her behalf. It really, really, really helps.