AML2 - Pippa Downs

As you might guess, we are learning so much more about Acute Myeloid Leukemia than we ever thought we
would. Here are some things we have learned as they apply to Pippa’s diagnosis, treatment, and prognosis. The
following excerpt explains things a little more scientifically and perfectly parallels Pippa’s situation from the
beginning of our story, 3 weeks ago today when her blood counts sent us to the ER and then to Loyola where she
had her first bone marrow biopsy.
“Most patients with AML have too many immature white cells in their blood, and not enough red blood cells
or platelets. The white blood cells may be myeloblasts (often just called blasts), which are immature blood-forming
cells that are not normally found in the bloodstream. These immature cells do not function like normal, mature white
blood cells. These findings may suggest leukemia, but the disease usually is not diagnosed without looking at a
sample of bone marrow cells.
The percentage of blasts in the bone marrow or blood is particularly important. Having at least 20% blasts
in the marrow or blood is generally required for a diagnosis of AML…in normal bone marrow, the blast count is 5%
or less. For a patient to be considered to be in remission after treatment, the blast percentage in the bone marrow
must be no higher than 5%.”
The great news is that after 7 straight days of 24 hour chemotherapy and the many excruciating side effects
which accompany it; and after a second, very painful bone marrow biopsy, Pippa’s marrow shows less than 1% of
these blasts! That is down from over 20% when she had the first biopsy, and it is less than the 5% doctors use to
determine if chemotherapy has been successful. That is indeed a wonderful answer to the many, constant prayers of
our family, friends, colleagues, and even people we do not personally know, but who are part of the Body of Christ
through the local, national and even world-wide Church.
In addition to this answer to the prayers for healing, please know that our God has also answered your
prayers for strength and peace. There is nothing normal about this for any of us and in the midst of long days,
sleepless nights and a life that is so different from anything we have ever experienced, there has been an incredible,
tangible presence that has “given strength to the weary and increased the power of the weak” (Isaiah 40:29).
Likewise, Pippa has mentioned that she truly believes that God has a purpose for all of this which will be in our and
others’ best interest and will bring glory to Him. Furthermore, the practical support for our family has been
nothing short of amazing. We are so thankful for “Grammy Downs” and “Oma Stehouwer” who have taken turns
to come and be at home with us and offer some stability; and many others have provided meals and cleaning and
grocery shopping and outings with the kids and yard work and general support and care which have made us feel
truly loved.
For now, the plan is for Pippa to stay in the hospital and wait for her blood counts to get back into the
normal range. We are hoping and praying that this can be done in 1-2 weeks so that she can be home for Hudson’s
birthday on the 27th and Thanksgiving! (Today is her birthday and although we are doing everything we can to
throw the best party the Oncology Unit at Loyola has ever seen, there’s still no substitute for Home, especially for
birthdays and holidays.) After being home for 2-3 weeks, the typical protocol is to go back to Loyola for
“consolidated chemotherapy” which is done on a 3 day per week outpatient basis. After that, there is still the
possibility of needing a bone marrow transplant.
However, we are taking things day by day. We are trusting God for mercies that are new every morning.
We are believing in His great faithfulness. We are resting in the Truth that He will provide strength for today and
bright hope for tomorrow; for tomorrow and for eternity by of the grace of our Lord, Jesus Christ.
Thank you again for everything!
Micah, Pippa, Stephanie, Wes, Sarah, Hudson and Lydia