Hope Graham recovers soon. Chz longest hospitalization was 8 days and it happened on the very last day of DI. He was 16 at the time. He had virtually zero ANC for a good number of days. I have asked his onc to give him the shots just to boost his WBC. Onc refused as they do not want to take any chances for the leukemic cells to multiply. He had numerous platelet transfusios and a few blood transfusions before being discharged. I do recall that during that long hospital stay, if he felt better, we would go out of the hospital  in the morning (after his med) and come back in time in the afternoon for his next med. You know how 16 y/o are - they get bored. During one of those hospital escape, it cost me an IPhone - but it was well worth it. You can see the BIG SMILE on the face of a very sick child. I think his ANC was <500 when discharged - only because there was no infection and no fever. It was amazing how quick the recovery was. We were on a cruise ship 7 days thereafter just to gorge on food.

We are now 14 months into LTM. It certainly is better than the first 6-7 months of intense chemo. Good Luck! You are a step closer to some normalcy. Godspeed!!!!!

Sorry to hear Graham is stuck in the hospital. Dylan's(7 y.o., dx. 12-1-08, HR-SER ALL-due to MRD) been hospitalized a number of times due to fever with 0 ANC. Our doc's rule is 2 days fever free and 2 days of rising counts(not just ANC but hemoglobin and platelets also). Dylan was at 0 ANC one time for 3  weeks and then discharged when it finally rose to 27. Most of his other visits have been from 1-2 weeks waiting on ANC to come up from 0. I am surprised they are giving the neupagin. Maybe its different for teens due to being higher risk, but our onc's do not use neupagin at all for their leukemia kids unless its relapsed because of the risk of boosting production of blast cells. Even after a 9 1/2 week delay for Dylan to be able to start Interim Maintenance, they wouldn't even consider using it when I asked. Anyway, I do hope that Graham's counts start coming up for ya'll soon. Long hospital stays are rough.

www.caringbridge.org/visit/dylankinsey

Justin was dx'd age at 10 (11 now) the same month as Graham.  We are now in LTM, but had 8 hospital admissions between Induction and DI for fevers.  Our longest stay was 14 days, and I know the hospitals like to wait for the ANC to be over 500 with no fever for 2 days before they let you leave.  I think the ANC is up to the doctor's discretion though.  Our last stay at the end of DI, our doc just wanted to see an upward trend with the ANC, and let us go with it being 99 on day 8.  The interesting part is that the nurse practitioner wouldn't let us go, but he could.  He also said he trusted us to bring him back in if necessary.  I know how frustrating it is.  Neupogen was mentioned at our last stay, as was checking his IgG levelswhich many on this board suggested we do first.  He ended up not needing anything, and his IgG levels came back as on the low end of normalso we will keep that in mind for the future if necessary.

I hope you guys can get home soon!

Tonya

No 500 rule for us, but we did always need to be 48 hrs. fever free.  However, it sounds like there is more going on than just low ANC.  When we were there, it has always been low ANC and fever.  No transfusions or anything else.  So- I imagine our team would have kept us longer if there had been transfusions as well.

Did they draw cultures as well? Our hospital would have admitted for that but all are different.  For example if they drew cultures and she is eating and drinking fine then some docs may decide that she can stay home unless something comes back on the culture that the antibiotic you were given didn't cover.  Because if it is just a virus and she is at least drinking well many would determine that there is no need to admit unless she stops drinking and becomes dehydrated.  But I personally would have wanted cultures drawn before they made the decision that we should stay home.  Just my personal opinion.