Acute Lymphoblastic Leukemia - ALL - in the Family
Cousins Beat Leukemia
“Leukemia” does not hold the same weight as in the past. Fifty, thirty, even twenty, years ago, leukemia connoted tragedy. Survival rates were abysmal; before 1962, no children survived and by 1970, the average survival rate hovered around 40%.
By 2011, the average survival rate has increased to 90%. Now, if a child acquires cancer, “this is the one to get,” said Dr. Kelly Maloney, an oncology physician at the Children’s Hospital Colorado and professor of pediatrics at the University of Colorado School of Medicine. “Leukemia is very treatable.”
Kevin gets a 1% chance to live, nearly 30 years ago
In 1987, Kevin Haring was diagnosed with acute lymphoblastic leukemia (ALL) at Children’s Hospital Colorado. Despite research breakthroughs and higher average survival rates, as an older child with the disease, doctors gave 11-year-old Kevin a 1% chance to live.
“Everything was normal around us, but our world was shattering,” said Kathy Babbel, Kevin’s mom. “At the time, I thought, ‘He was just playing baseball the other day.’”
Kevin’s leukemia began with an ear infection, a sinus infection, face paralysis and strep throat. Suspicious that a serious condition lurked beneath the surface, Kevin’s primary care physician sent him to Children’s Colorado where doctors performed a bone marrow test and spinal tap on Kevin. The tests confirmed that he had leukemia.
“By that point, he was very involved with the disease,” Kathy said. “I was devastated. I kept thinking they’d made a mistake, that it was someone else’s blood.”
The Future of ALL
Researchers are currently trying to understand “what is individual about leukemia,” Dr. Maloney said. Although leukemia is not hereditary, the way it manifests in an individual patient could be genetic. This means genetics can predict how a patient will respond to treatment – will he need intense chemo or can he survive with a lighter treatment plan? To this end, patients could experience fewer side effects and may look to an even better cure rate.
Ethan Brown, Kevin’s cousin, is currently enrolled in a standard risk leukemia trial that aims to extract parts of chemotherapy treatment that may be unnecessary to his long-term well-being. It was this kind of study that eliminated radiation from most ALL treatments. According to Dr. Maloney, physicians now aim for the same cure rate with fewer medications.
Dr. Lorrie Odom, an oncology physician at Children’s Colorado in the 1980s, treated Kevin and invited him to participate in research. He enrolled in a blind trial, one of three national protocols conducted at Children’s Colorado during that time. Kathy described Kevin’s protocol as “fairly new;” the treatment plan entailed six weeks of radiation and three years of chemotherapy. It would record much success in the future, becoming one of the standard treatments for ALL patients and responsible for the drastic increase in survival. Although radiation is seldom used to treat ALL today, chemotherapy has changed little since Kevin’s treatment.
Now, more than 20 years after Kevin’s diagnosis, more than 50 years since leukemia recorded its first survivor, Kevin’s cousin, Ethan Brown, 5, has acquired ALL.
Ethan has a 96% survival rate today
Kevin and Ethan’s stories follow similar trajectories. Like Kevin, Ethan began with a string of vague illnesses. In October 2010, Ethan’s leg began to hurt without explanation. A few days later, the pain spread and he had problems sitting up. When he presented these symptoms to his physician, Dr. Joe Smith, he tested positive for strep throat. Despite antibiotic treatment, Ethan’s fever persisted. He developed a rash and purple dots under his skin. Then one morning Ethan woke up covered in bruises, a telltale sign of leukemia.
Children’s Colorado diagnosed Ethan with ALL on November 9, 2010. Ethan entered into remission soon after treatment began, his cancer presumably gone; like Kevin, Ethan will undergo three years of chemotherapy. But unlike Kevin, Ethan, at 5 years old (a common age to acquire ALL), has a survival rate of 96%.
“First you have to cure kids,” Dr. Maloney said. “Then you try to make the treatment better.”
Kevin and Ethan: Cancer-free cousins
Kevin and Ethan see each other from time to time, usually at family gatherings. They compare medications, Ethan reciting scientific names and Kevin nodding in agreement.
Today, Kevin lives in Denver and works for FedEx, cancer-free for 24 years. He is stoic, calm – a hint of how he must have handled his leukemia. When he reflects, it is with optimism and gratitude. Most things are minor compared to what they could have been, he says.
Ethan, on the other hand, doesn’t appear to ponder his fate – he’s too busy playing with cars and legos.
“Ethan is so spunky,” Dr. Maloney said. “He is playing despite what has come his way.”
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