High Neutraphil counts

My son is 5 years old and we are currently 6 months into his maintenance protocal on the Standard Arm Protocal.  We have had to triple his doses so far.  His neut counts haven't dropped below the 1.5 of what they are looking for.  They have ordered metabolic test but the results are not back yet.  At the time of diagnosis he was put into the Average Risk group due to a high WBC.
Can you please tell me what exactly the test is looking for and how this can effect his treatment.  I am aware that some people have a resistance to chemotherapy, can a bone marrow transplant be an effective treatment if the Chemo isn't working?
Is it also possible that the chemo is still working even though his counts are not dropping?  He has never really been sick from the treatment, the only drugs that have had any adverse effects on him were the Doxorubicin and L-Asparaginase.

Thank you for your valuble time

[Katey H.]

I know what you're going through, I'm currently in remission. ALL can be extremely tough to beat. I think the test you mentioned is a comprehensive metabolic panel.  It's used to see how well the liver, kidneys are doing and to monitor acid/base levels, glucose and proteins in the blood.  Electrolyte (Ca, N, Cl,) imbalances can be dangerous and are common with diseases like ALL.  It also measures the BUN(blood urea nitrogen) of the kidneys and the ALT, ASP, ALP(enzymes) of the liver to see how well they are functioning.  High neutrophils can be caused by kidney failure when ketones (acids) are produced by the body.  High neutrophils can also be a sign that the cancer is spreading, despite chemo.  If the counts aren't dropping, the chemo probably isn't enough.  A bone marrow transplant (BMT) may be in his future, they are extremely risky, but are possible.  I had a BMT because I had a very high risk ALL, but if your son is still in the "average risk group" they may not want to resort to a BMT just yet.  I hope this info helps.  I wish you the best of luck, keep me  posted.

Katey