Kezia started the first maintenance phase today with Vincristine and Dexamethasone. She was also meant to start mercaptopurine and oral methotrexate but these are neutrophil and platelet count dependent and and her neutrophils had not recovered sufficiently. This was expected. Her next visit is next Tuesday, I suspect just to see if her counts have recovered enough to start these medications
Maintenance cycles run in 12 week blocks. Every 4 weeks is Vincristine (one dose) and Dexamethasone for a week, Mercapturine every day and oral MTX once a week apart from the third week of each cycle when she will receive intrathecal MTX. All the maintenance cycles follow the same pattern until the end of treatment. For girls there are six maintenance cycles, boys get more.
The Hickman Line will be removed - but there is currently a three-month waiting list for this surgery. They will not install a Portacath unless she becomes very fractious with the Vincristine injections.