April 25, 2019

We finally received the genetic results yesterday that identify Bo’s subtype of Acute Myeloid Leukemia (AML). There are a number of different subtypes of AML, some are associated with more positive or negative outcomes, many are neutral. We received the results that Bo’s subtype falls into the category of neutral, which for the time being means no change in prognosis or course of treatment. It does mean that we don’t have all the answers we were hoping for, so there is more waiting and will be more testing to determine if any change in treatment is needed.

We also received results from his spinal tap on Tuesday, and the findings were the same as the previous week’s: the leukemic blasts were still present but at a very low occurrence. It is confusing because he had 2 clear results previously, and now he’s had 2 blast-positive results. Our oncologist reached out to the pathologist for further clarification, and the concern is that whatever blasts are in his cerebral/spinal fluid (CSF) might not be responding to the chemo. There is not a clear plan forward at this point regarding the CSF, but no more spinal taps will be happening for the next few weeks to give his body a break. Bo will be having an MRI on his spine tomorrow to look for any leukemic deposits that could explain the resurgence of blasts in his CSF. Prayers for that are appreciated, although we don’t have a specific time yet!

They have told us that it is likely that we will go home next week! Although we will only be home for a week before returning, we can’t wait to spend that week with Naomi doing all of the normal things we so often took for granted!

Here’s what we do know about what’s to come: Bo will have another bone marrow biopsy and spinal tap when his cell counts recover enough to be tested, most likely during the first part of May. The bone marrow biopsy will tell us if the chemo this first round was effective and the spinal tap will tell us if they need to be more aggressive with his CSF or if he will be sent straight to a bone marrow transplant. We have learned quite a bit about transplant, and although it is intense, the outcomes are very encouraging.

I wish we had more definitive answers, but it feels like God is keeping us dependent, which is right where we want to be anyway. Prayer for Bo’s complete healing is still at the top of our list, but would you also pray for our hearts that they would be full of trust in a God who is able, especially in the face of still so many unknowns. We are grateful for each one of you!

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