Acute Lymphoblastic Leukemia

Dr. Bruce came in the next day and confirmed that Jessica had Acute Lymphoblastic Leukemia (ALL). Leukemia is a cancer in the cells of the blood. There are two types, Acute and Chronic. Acute is characterized by a massive development of immature white blood cells that interfere with and block out mature white blood cells. With Chronic forms, the white blood cells become mature, but they are abnormal and do not function properly. Acute patients are the ones that may exhibit anemia, bruising, bleeding and infections. Without treatment, Acute patients have an average survival of three to five months after diagnosis while Chronic disease is easily controlled with medication and average survival is measured in years rather than months. Of the Acute Leukemias, 80% are adult patients with the Acute Myeloid form, the other 20% have ALL, which is similar to the childhood form of leukemia.

Bruce told us that both Leukemia and Lymphoma are blood born diseases, but that is where the similarity ends. While Spencer's battle was all uphill, Jessica had all the markers for survival. She was female, white, between the ages of 6-9 years old and most importantly, we caught it early. Remember that only a year earlier, she had been screened to be a bone marrow donor and nothing was seen then. Also, we had just been in New Hampshire that summer and had climbed Mt. Major which is a long and grueling hike. Jessica exhibited no signs of fatigue or anemia. She never had any bruising or bleeding. All good news, but we were still reeling from the fact that this was our second child with a malignancy.

The doctors were baffled too. In the coming months we were interviewed extensively, family histories were documented. We were tested for the P-53 gene, which is a marker for family malignancies (negative). They even had a research team from the University of Minnesota come to our house in Manayunk, an old industrial area of Philadelphia, to do testing. They took water and soil samples, set up radon and electromagnetic detectors, and even vacuumed our rugs with this "back to the future" looking vacuum cleaner. The results were inconclusive. We had slightly elevated electromagnetic fields which could be attributed to the old knob and tube wiring in the house, the electric lines and transformer on the street in front of our house, or the train power lines three hundred yards away. All unlikely, or at least minimal contributors. Bottom line, they didn't know and no one was keeping records. For example, they didn't even have a list of cancers, pediatric or otherwise, matched with zip codes that might signal "hot spots" for cancer occurrences. Even Sandra's pregnancy with Lauren was screened as a high risk pregnancy. At that point, we were growing weary of stupid questions and retelling our story.

So Jessica was kept on a chemotherapy of Methotrexate and Prednisone (steroid) was added to force the chemo into all of her body's nooks and crannies. We were back to tag teaming in the hospital, we had a lot of visitors. The day surgery was on a Wednesday, but by Saturday Jessica was sent home on a pass. Her treatment would happen on more of an outpatient basis, she would go to the oncology clinic weekly in the Wood building behind CHOP for examinations and chemotherapy infusions. The plan was for her to receive intensive chemotherapy for six months to push the cancer into remission and then 18 months of maintenance therapy to keep it away. Within two weeks she started having abdominal pains and her hair started falling out.