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Childhood Leukemia

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A couple of years ago a world renowned medical journal, The Lancet, took note of how survival rates from childhood leukemia surged in the 1970s and 80s, from less than 20% to over 80%. There was no miracle drug, no new genetic discovery, not a single new chemo-therapeutic agent introduced. Instead, researchers inched their way forward, gradually finding better and better drug combinations, dosages and sites of injection.

As The Lancet stated, "The story of leukemia epitomizes how modern medicine really advances.” Which brings us to the latest installment in our special series, “About Blood.” ideastream’s Anne Glausser has one story of survival from the most common form of childhood cancer…made possible by painstakingly small steps and persistence.

Thursday, May 10, 2012 at 6:00 am

LOCKE: Knock, knock, hey, so we’re going to put these gowns on…

I followed Angela Locke, a child life specialist at Rainbow Babies and Children’s Hospital, into the room of one of her patients.

BERENDT: Matthew Berendt. I’m six years old.

Matthew is from Cortland Ohio, just outside of Youngstown.

He’s got a few tufts of blonde hair but the chemo’s wiped out the rest.

He has acute lymphoblastic leukemia, or ALL. It’s one of the most common forms of childhood cancer.

LOCKE: So what are we going to learn about today? BERENDT: I don’t know. LOCKE: We’re going to learn about leukemia by making pretend blood.

Locke’s brought a tote bag full of “blood-making” materials, and she asks Matthew where they should begin.

BERENDT: I think the marshmallows. LOCKE: Ok, so… BERENDT: I think I want to eat one.

Locke’s known Matthew since his diagnosis, over a year ago. Her role is to help kids cope with their conditions, through stuff like this demonstration, or puppets, or just being accomplice to the occasional stolen marshmallow.

Locke explains that the marshmallows represent white blood cells, which fight infection. Red hots are red blood cells that carry oxygen, and rice stands in for platelets that stop bleeding.

LOCKE: So when the doctors looked at your blood Matthew, they were looking at your white ones and your red ones and your platelets, but they also saw a different type of cell in your blood too. These ones are called leukemia cells.

Locke scoops bits of Styrofoam into their bag of “blood.”

Leukemia cells are white blood cells gone wrong. They crowd out good cells and invade bones and other organs.

Chemo--in this demo, nail polish remover--helps stop the leukemia in its tracks.

(Sounds of dissolving Styrofoam)

BERENDT: I see one more leukemia.

LOCKE: You want to make sure that chemo’s touching it?

He jiggles the bag so the acetone hits the remaining foam bits.

This kind of demo is good to repeat with kids, Locke says—it helps them understand what’s going on in their bodies.

Berendt is smart, and curious. After the demo, we start talking snakes…

BERENDT: I know all about them.

…and aquariums…

BERENDT: But what happens if you pet a stingray?

…and his ambitions for the future…

BERENDT: Someday I’m going to go to the Cleveland Zoo.

LETTERIO: The most common form of childhood cancer is virtually curable in every child.

Dr. John Letterio is head of the pediatric oncology program at Rainbow Babies.
He has a deep appreciation for the research and trials that have, over the years, led to better treatments. Now kids like Matthew Berendt have very favorable odds.

LETTERIO: In the early 60s if you were diagnosed with ALL you probably had somewhere between 10-15% chance of being a long term survivor. So you can see just in three decades, we’ve taken a disease that was nearly uniformly fatal to making it something that’s almost always cured.

According to a recent article in the New England Journal of Medicine, cure rates for acute lymphoblastic leukemia are now pushing 90 percent, though some kids have variations of leukemia that are harder to treat.

Doctors use aggressive chemotherapy to knock back the cancer. And sometimes, the chemo is paired with a bone marrow transplant.

LETTERIO: Yeah it sounds like a complicated procedure but it’s actually, it’s like hanging a blood transfusion.

Letterio says bone marrow transplants are really just a way to get good blood cells back into the body.

Matthew Berendt will get a transplant soon, from his brother. He’s been on intensive chemo so he needs a fresh stock of healthy blood cells to repopulate his body.

The real test is in the weeks after a transplant. Will the body accept the cells and start building healthy blood?

For now, Angela Locke whispers in Matthew’s ear to remind him of the good news. After several rounds of chemotherapy, he can announce that tomorrow….

BERENDT: I’m going home.

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