Friday, October 13, 2006

Platelets today

Dylan is still doing well. He had a platelet transfusion today and he also started back on GCSF injections because his white blood cells are dropping again. We will return to clinic on Tuesday for a CT scan, MIBG injection and CBC blood test. I saw Dr Modak today who said that Dylan’s hot 3F8 commencement date will be delayed for a further 4-5 days as the 2nd patient on the study was delayed, which pushes the rest of the dates forward. With a further burst of disappointment of waiting longer, I decided to turn a negative into a positive and being happy that Dylan will not have to spend is birthday having therapy. He was initially scheduled for the 9th November and would have been hospitalized for his birthday on the 10th. This way he will be able to have a bit of a celebration over that weekend and be feeling good. The new date is now 13th November. I have the official pathology report from the lymph node surgery which says that 2 lymph nodes were removed. Diagnosis: Ganglioneuroblastoma with marked nuclear pleomorphism (Anaplasia)

Definition of Ganglioneuroblastoma: A tumor arising from nerve tissue which is intermediate between benign (slow-growing and unlikely to spread) and malignant (fast-growing, aggressive, and likely to spread)

Dylan has Neuroblastoma, and it is still present in his bones and marrow (skull, ribs, spine, hips and pelvis) So why does the report say Ganglioneuroblastoma wa found in his lymph nodes…well it is the same thing, just at a different stage of cell maturity, at least that is how I interpret it.

Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma are tumors of the sympathetic nervous system that arise from primitive sympathogonia and are referred to collectively as neuroblastic tumors. They arise wherever sympathetic tissue exists and may be seen in the neck, posterior mediastinum, adrenal gland, retroperitoneum, and pelvis. The three tumors differ in their degree of cellular and extracellular maturation; immature tumors tend to be aggressive and occur in younger patients (median age, just under 2 years), whereas mature tumors occur in older children (median age, approximately 7 years) and tend to behave in a benign fashion. The most benign tumor is the ganglioneuroma, which is composed of gangliocytes and mature stroma. Ganglioneuroblastoma is composed of both mature gangliocytes and immature neuroblasts and has intermediate malignant potential. Neuroblastoma is the most immature, undifferentiated, and malignant tumor of the three.

Yes the plane that crashed into the apartment building in Manhattan was a block away from us! 73rd Street (our street) was like 5th Ave, with hundreds of people running up and down on their cell phones. Helicopters buzzing loudly around and a sea of police, ambulance and fire vehicles. Some people were crying in the streets as it brought back many memories of 9/11. Police ushered people off the streets and finally closed off the surrounding streets including ours, along with 1st and York Avenues. Loads of police buses arrived and literally hundreds of police officers were piling out with all sorts of breathing equipment. Then the rain came down which enticed many onlookers to go home, and by the evening the streets re-opened, although there was still a very strong police presence. The biggest fear was if the building collapsed. Today there is still news crews camped on York Ave with camera’s pointing to the building, I think they are there so that if it does collapse, they will get it on film. The immediate block that the building is in is still blocked off. Dylan and I had our first look at it on our way to hospital this morning, we could clearly see the floors that were hit by the plane.