Bone Marrow Transplant: Brianna's Battle with Leukemia
"She really wants to have an impact on the world."
A cured cancer survivor, Brianna is a member of the Long-Term Survivor Program at Cincinnati Children's where she has annual checkups. She is pictured here with her mom Lyssa.
At just 9 months old, Brianna was diagnosed with acute lymphoblastic leukemia (ALL). Her family was told she would need a bone marrow transplant. Before she could even walk, Brianna began receiving chemotherapy, a treatment that is challenging for even the strongest of adults. On September 12, 1994, at age 1 and close to a relapse, Brianna underwent a bone marrow transplant and remained at Cincinnati Children's for the next month and a half. Today, at age 14, Brianna is part of the Long Term Survivor Program at Cincinnati Children's and taking all honors classes at school.
In April 1994, Lyssa Bookman took her daughter, Brianna, to the pediatrician for what she thought would be a routine 9-month well-baby checkup. The doctor said Brianna looked healthy, but he wanted to run additional blood tests because Brianna had low levels of hemoglobin, the portion of red blood cells that carries oxygen from the lungs to the body tissues. Lyssa would soon hear the words every parent fears most: "Your child has cancer."
Brianna was diagnosed with acute lymphoblastic leukemia (ALL). This type of leukemia, the most common type diagnosed in children, is a disease of the bone marrow in which the production of normal blood cells is drastically decreased. Fortunately, cure rates now exceed 80 percent. But Lyssa was told her young baby probably would not live long.
Two days after Brianna was diagnosed, her family was told she would need a bone marrow transplant. Before she could even walk, Brianna began receiving chemotherapy, a treatment that is challenging for even the strongest of adults. By July, as Brianna was approaching her first birthday, it had been determined that none of her relatives were a match for a bone marrow transplant. At that time, the Bookmans were referred to Cincinnati Children's. They drove 120 miles from their home in Columbus, Ohio, and were relieved to learn that a bone marrow match was found. On September 12, 1994, as she was close to relapsing, Brianna underwent her transplant and remained at Cincinnati Children's for the next month and a half.
What Is a Bone Marrow Transplant?
A bone marrow transplant (BMT) is not a surgical procedure. In other types of transplants, such as heart and liver transplants, a surgeon removes the diseased organ and replaces it with a healthy one. Bone marrow transplantation, however, is more like planting seeds and making them grow. The seeds are stem cells.
Healthy bone marrow contains stem cells that produce blood cells, including red blood cells that carry oxygen and white blood cells that fight infection. But the bone marrow can be destroyed by high doses of chemotherapy and radiation that are used to kill cancer cells. Treatment that sacrifices the bone marrow is only possible because of the ability to rebuild the marrow through transplantation.
BMT patients receive healthy stem cells that have been collected from a donor's bone marrow or blood, or from umbilical cord blood. The new cells are given through an intravenous line in a procedure similar to a blood transfusion.
The new cells circulate in the blood stream and settle in the bone marrow, where they begin to grow and to produce blood cells. This stage takes several weeks, but the process of fully rebuilding the bone marrow takes much longer. It takes about a year for the immune system to become fully competent.
A Bright Future
Today, at age 14, Brianna is part of the Long Term Survivor Program at Cincinnati Children's and taking all honors classes at school.
After her transplant, Brianna was developmentally delayed. At 14 months old, her behavior mirrored that of a newborn. To address these delays, Brianna was exposed to a full range of support within Cincinnati Children's, including play therapy and music therapy. Through years of hard work and determination, Brianna is proud to report that she is now, at age 14, taking all honors classes.
Brianna has been in the Long Term Survivor Program at Cincinnati Children's since the age of 6. Now preparing to enter high school in the fall, Brianna looks forward to her classes and being involved with her school's drama program. Ultimately, she hopes to find a profession where she can have a positive influence on others. Says Lyssa, "She really wants to have an impact on the world."
"The Memories Are Still Fresh"
Lyssa has no reservations about making the two-hour drive from Columbus to Cincinnati for Brianna's care. "The continuity of care at Cincinnati Children's is phenomenal," she says. "You have one doctor, one nurse, one nurse practitioner who are with you through everything. Brianna's doctor has watched her grow up." To this day, Richard Harris, MD, continues to see Brianna at her yearly checkups.
"I can't say enough about how wonderful it was at Cincinnati Children's," Lyssa says of the time spent at the hospital after Brianna's transplant. "It feels like yesterday because the memories are still so fresh in my mind. The nurses went above and beyond and took care of our entire family."
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