Neutropenia
The absolute neutrophil count (ANC) is the real number of white blood cells that are neutrophils, the most common type (between 50-70%) of all white blood cells. They are phagocytic, meaning that they can ingest other cells, and are the first immune cells that arrive at the site of infection. When the need to fight infection arises, they move to the site of infection by a process known as chemotaxis, usually triggered by cytokines released from macrophages that sense invading organisms. At the site of infection, they engulf and kill bacteria. Eventually, the neutrophils die, and these dead cells are then phagocytosed by macrophages, which break them down further. Pus, therefore, is the viscous material composed of these dead neutrophils.

A deficiency or absence of neutrophils is called neutropenia, which is a common occurrence in cancer patients undergoing chemotherapy and other forms of treatment. A normal ANC is anything above 1,500 cells per cubic mm, and a “safe” ANC is in the range of 500-1,500, although this is a moderate form of neutropenia. An ANC below 500 is considered severe neutropenia.

Justine’s ANC levels were at zero (0) a few days ago, but they are rising steadily. This means that while Justine gets to spend some time at home, she won’t be entertaining visitors until her ANC levels are normal.

Platelet Donation
Platelet donation is still the best way all of us can make a direct impact on Justine’s recovery and she’ll need even more when chemotherapy starts up again next week. Because the process takes approximately two hours, appointments are required for platelet donation. Please visit the Donating Platelets page for more information, or call CHLA’s Raul Gonzalez directly at 323-361-2441 to make an appointment.

Graduation
Justine is scheduled to graduate from the 8th grade in a few weeks, and although she hasn’t been attending school, she is being tutored by her mom, Mita, who is a high school teacher. Justine is an honor student, and she’s getting most of her homework done on her own…with a little help from mom. She won’t be able to graduate with her classmates, but the school district is making arrangements to present Justine with her diploma at Childrens Hospital Los Angeles, and the hospital is generously allowing us the use of one of their conference rooms for the ceremony.

Thank You
The love and support of family and friends has been overwhelming, and Justine’s strength and determination throughout this ordeal has been inspiring. Please keep Justine in your thoughts and prayers as she continues her fight!