After an enjoyable week at home, we have now returned to Barnes Jewish Hospital in St. Louis to begin the Consolidation Phase of Kristin's AML treatment. During her previous 31 day hospital stay, Kristin successfully completed the Induction Phase of treatment. She responded very well to the initial chemotherapy treatments, and her bone marrow is now producing normal blood cells. However, to ensure that she remains cancer free, she will need additional treatment. Yesterday marked Day+1 of a 28-35 day cycle that Krisitn will need to complete a total of 4 times in order to ensure that she remains in a remission cycle.

At the beginning of each cycle, Kristin will be an inpatient here at Barnes for 5-6 days. During her stay, she will undergo 6 rounds of HiDac Chemotherapy.  Each round lasts about 3 hours, where she receives an extremely high dose of the chemotherapy drug Cytarabine via her IV port. This is the same chemo drug that she received during the 7+3 portion of her Induction treatment, but at much higher doses and over a shorter period of time. On Day+6, if there are no complications, she should get to come home. Day+8 begins a 14 day course of treatment for her FLT3 mutation, without which the chemotherapy would likely be ineffective. This is an obsenely expensive oral medication that has only been FDA approved since April 2017, that she will take twice a day. Additionally, during this time frame, she will need to go to the Peitz Cancer Center in Mountain Home every few days for blood work, misc. IV medications, and blood product transfusions. Just like her previous treatment, she will likely need multiple transfusions of both blood and platlets. On Day+21 she will complete her course of treatment and have 1-2 weeks to rest and recover before returning to Barnes to start the cycle over again. The goal of the 4 rounds of Consolidation Phase treatment is to keep the AML in remission for an extended period of time. If her AML does not respond to the chemotherapy, then the next step will be a Hematopoietic Cell Transplantation (HCT) transplant.