Pediatric AML, or Acute Myeloid Leukemia, is a collection of deadly blood cancers. It is resistant to treatment and known for relapse. As such, the treatment of AML is aggressive and often unrelenting. Because this cancer lives within the myeloid cell, it impacts the child’s ability to create red and white blood cells as well as platelets, paralyzing the immune system. Traditional chemotherapies obliterate all myeloid cells. This results in a child who is unable to make blood or platelets and is prone to life threatening infections and illness at key points in treatment. Many children then have to endure a stem cell transplant, where the existing immune system is wiped clean, making room for donor stem cells. Pain, chronic damage to organs, and massive weight loss are a few of the more minor side effects in the initial stages of transplant. Engraftment occurs when the marrow begins making new cells, with the ultimate hope that the donor’s immune system will fight any residual or returning disease. But despite this brutal treatment protocol, the cancer often returns. Stem cell transplants are life-altering. Doctors and parents refer to the transplant process as ‘bringing a child to the edge of death.’As a parent, witnessing this process makes you wonder: which is worse, the cancer or the treatment?
This is why precision treatments are critically needed. Treatments like those being researched at Fred Hutch Cancer Center for Project Stella. Immunotherapies target only the leukemic cells, leaving the healthy cells unharmed. They are effective. They are tailored. And most importantly, they don’t require a child to be brought to the edge of death.
To learn more about Pediatric AML or about other forms of Cancer click on these hyperlinks.
Graft-versus-host disease (GVHD) is a potentially serious complication that arises from stem cell/bone marrow transplants. GVHD occurs when the donor’s T cells (the graft) view the patient’s healthy cells (the host) as foreign, and attack and damage the patient’s cells. GVHD can be mild, moderate or severe and in some cases, it can be life-threatening. Ella battled moderate/severe GVHD in her gut shortly after transplant, the scariest and most difficult part of her treatment. She was unable to eat, drink, or even lift her head for weeks. She wasted away and was in constant pain as the walls of her intestine were shredded by her donor’s cells. Healing took several months, three of which were inpatient, and it very nearly killed her.
Sounds awful, right? But here’s the thing. GVHD can also promote something called graft vs. leukemia (GVL). Basically, the same donor cells that attack the patient also search out and destroy leukemia lurking in the patient’s body. Doctors walk a tight rope of letting just enough GVHD into the patient to cause GVL, without allowing the GVHD to run rampant. For some forms of leukemia, a transplant is strong enough to ensure remission, so GVHD is prevented as much as possible. But for AML-RAM, GVHD is almost essential to secure remission. Nothing about that fact feels right. It means that though kids may survive, it is unlikely they will thrive. We have said repeatedly that ‘Ella may need a lung and heart transplant down the road, but at least she’ll be alive.’ That is a bitter pill to swallow. And that is why it is so critical for us to continue pushing for better, more tailored treatments through Project Stella.
A blood cancer diagnosis marks the start of a race against time. For many patients, the only chance of survival is to find a matching bone marrow or blood stem cell donor as quickly as possible. The impact of a donation on a child is truly lifesaving, but not all children are able to find a suitable donor in the registry. This means a parent hears "your child needs a transplant to survive but we can't find a match. I'm so deeply sorry." That is unacceptable. This at the heart of the DKMS and the Be the Match missions - to find matching donors for every patient.
Joining the registry is as simple as swabbing your cheek and sending it in! The donation process itself is fully paid for, quick, and painless.
Tears flow as Cody meets the recipient of his stem cell donation