Patients with < 5 leukocytes per mul of CSF and the presence of leukemic blast cells on CSF cytospin (CNS2)will receive weekly intrathecal therapy until the CSF is free of blast cells. These patients will then receive 4 additional doses of intrathecal therapy at approximately 1-month intervals (generally given with each subsequent course of chemotherapy).They have currently treated for this twice with methotrexate, hydrocortisone, and cytarabine injected into her spinal fluid. Each time they test to see if there are still blast cells. The test from the second injection showed no more blasts in her CSF, so that means that she is back to the original protocol (1-month interval spinal injections). I hope that it is a good sign that she responded so quickly!
Friday, September 10, 2010
CSF Free of Blasts
That would be Clara's Cerebrospinal fluid is free of the leukemia cells that are circulating through her system. Initially they discovered 2 leukocytes per mul in Clara's spinal fluid. They first discovered this when we first came in for possible meningitis. Here is the treatment plan for this situation: