The road map

At this point, we have a fairly good idea of what to expect regarding the chemotherapy part of James' treatment schedule for this month. I'll go ahead and just list back from the 28th of February through the end of March as things are currently scheduled. Please note that things like infections, reactions, blood and platelet transfusions are not scheduled but do occur.

Wed, Feb 28--arrive at Cancer Clinic
Thurs, Mar 1--Surgery, install central line (Hickman), bone marrow aspiration, bone biopsy, spinal tap, chemo in spinal fluid (don't have the name handy); begin dexamethasone (steroid, which will run for 28 days then taper off) First dose of vincristine (a very potent chemo drug).
Fri, Mar 2-Mon, Mar 5--remain at hospital, continue all other meds.
Tues, Mar 6--Asparaginase, intra-muscular chemo treatment
Wed, Mar 7--remain at hospital, continue all other meds.
Thursday, Mar 8--Bone marrow aspiration, bone biopsy, spinal tap, chemo in spinal fluid. This is a very important day for James. The hope is that he will be declared in remission. If he is, his prognosis is very good. If not, we'll have to do the bone marrow aspiration and bone biopsy again in a week. James will also get his second dose of vincristine.
Fri, Mar 9- Thurs/Fri, Mar 15/16--Lord willing and all goes well, we'll go home for a while. There is a great possibility that James' numbers will drop, he will get a fever and we will end up back in the hospital for antibiotics.
Thurs/Fri, Mar 15/16--Depending on the results from last weeks bone marrow test, it may need to be done again this week. Otherwise, we would return to the hospital for James' third vincristine dose. Lord willing, we'll return home on the same day. Depending on how he handles this treatment, we may need to remain overnight.
Sat, Mar 17-Thurs Mar 22/Fri Mar 23--Lord willing and all goes well, we'll go home for a while. Again, there is a great possibility that James' numbers will drop, he will get a fever and we will end up back in the hospital for antibiotics.
Thurs Mar 22/Fri Mar 23--Return to the hospital for vincristine dose. (Close on the house Mar 23rd)
Fri/Sat, Mar 23, 24--Thurs/Fri, Mar 29, 30--Lord willing and all goes well, we'll go home for a while. Yet again, there is a great possibility that James' numbers will drop, he will get a fever and we will end up back in the hospital for antibiotics.
Thurs/Fri, Mar 29/30--Return to the hospital for vincristine dose. Have bone marrow aspiration and bone biopsy and spinal tap.

At the end of the month, all the results of James' treatments so far will be submitted to the Children's Oncology Group (COG) and they will determine which specific track of treatment he will follow (at least that is how I understand it).

The treatment will last for another eight months and then, if all goes well, James will move into the maintenance phase where he will probably have maintenance treatment for another 29 months for a total of 3 years, 2 months.

So, this is a start and it is all subject to change depending on how James responds to therapy and how healthy he is able to stay during treatment.

Stephanie