This stage lasted 7 weeks, and was split into 2 parts.
It was the intention, that she’d have 4 weeks on, 1 week off, then 2 weeks on. But Hannah had more delays due to being neutropenic, 3 weeks delays in total. She also had a few infections to contend with, she was able to finish this stage just before Christmas.
Here is a breakdown of Hannah’s fourth intensive stage of treatment:
Dexamethasone – For 21 days, 3 times a day.
Thioguanine (oral) – For 28 days, once a day.
Vincristine – Through IV, for 4 days, day 1, 8, 15, 22.
Daunorubicin – 1 hour infusion, 4 days, day 1, 8, 15, 22.
Asparaginase – Once, 1 hour infusion.
Cytarabine – Through IV, 4 times a week (consecutive days), for 4 weeks.
Intrathecal chemotherapy (into spinal fluid):
Cytarabine – Twice, day 1 and 15.
Prednisolone – Twice, day 1 and 15.
Thioguanine (oral) – For 14 days, once a day.
Cytarabine – Through IV, 4 times a week (consecutive days), for 2 weeks.
Cyclophosphamide – Twice, 1 hour infusion, on day 36 and 49.
She had another bone marrow aspirate on day 1. There were also multiple additional drugs she had to take alongside this stage, some to prevent infection, side effects and allergic reactions, others to treat infections whenever they appeared.