Hey Friends & Smartsheet Teammates!  We want to buy Andrew an iPad for the long road ahead of him, as the story and treatments are spelled out below.

As most of you know by now, Andrew was diagnosed with B-cell Acute Lymphoblastic Leukemia (B cell - A.L.L.).   The doctors have shared that A.L.L. is extremely rare in adults (this is usually only seen in young children) and especially those who are 28 years old and in top physical condition.  Andrew is always in great shape.  So, the diagnosis is surprising even the doctors.  The good news here however is that B cell - A.L.L. is supposed to be curable; so that’s our new goal.

The plan of attack going forward that makes a lot of sense. 
·        Andrew’s bone marrow biopsy came back negative for the Philadelphia mutation.  The doctors say that with the Philadelphia chromosome not being present, Andrew might not need a stem cell transplant.  Still too early to know for sure because we have to see how Andrew responds to the IV chemo. 
·        Since Thursday (1/18/18) Andrew has been taking oral chemo and steroids.  These medications have really been effective.  His white blood cell count has dropped from 424,000 (normal is <10,000) to about 6,200 yesterday morning.  Again, this is a very good sign.  His red blood cells and his platelets and many, many other tests are coming back strong.  More good signs.
·        Andrew just started with a spinal tap & direct chemo treatment in his spinal cord.  This is day one of what we are calling the 28-day war.

o   For the next ~28 days Andrew will be undergoing very aggressive chemotherapy treatments.  This is our aggressive attack on his cancer cells using IV chemotherapy.  The intent here is to kill off all cancerous white blood cells, red blood cells, stem cells and everything and anything in his body related to cancer.  The end goal of this attack is 100% complete remission.

o   After we successfully achieve full remission, we enter into another phase whereby we want to maintain that full remission over time.  Yup.  More chemo but perhaps we can get Andrew home during this ~9-week phase.  Massachusetts General Hospital works right alongside the Karmanos Cancer Institute in Detroit.  Andrew’s doctors are starting to arrange treatments for him at Karmanos so he can come home for a while.   Nothing like mom’s homemade cookies, Belgian sausage and cheesy potatoes to help this young man feel better!  We’ll see if/when we can swing getting him home.

o   During that 9-week phase there will be some days where Andrew feels GREAT and other days when Andrew feels very sick.  We will play it day-to-day, keep asking God for His grace & blessings and thank Him for all we’ve already achieved.

o   Should we successfully achieve 9 weeks of maintained remission, then we enter the next, more prolonged phase.  That is when Andrew should be able to get back to work while still maintaining a rather less taxing chemo treatment schedule.  Nothing 100% guaranteed but step by step. 

o   Andrew will be on chemotherapy for the next 2.5 years.  He will lose his hair.  He will be physically and emotionally challenged by his cancer and the life-saving treatments we have scheduled.  It will not be easy.  He will be cured.


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Ben Levien 
Bellevue, WA
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