How Bone Marrow Transplants Help Treat Acute Myeloid Leukemia
- A Texas boy named Preston, 13, received a life-saving bone marrow transplant from his little brother to battle acute myeloid leukemia.
- Preston called his brother a “real-life superhero.”
- According to the American Cancer Society, leukemia is a cancer of the early blood-forming cells and is the most common cancer in children and teens, accounting for almost 1 out of 3 cancers.
- Childhood acute myeloid leukemia (AML) is a type of cancer where the bone marrow makes a large number of abnormal blood cells.
- Treatment options for acute myeloid leukemia in children depend on the overall health, age, ethnicity of the child.
- The odds of finding a bone marrow transplant match based on ethnic background for people of color is lower than white people.
Not all superheroes wear capes. Some come in the form of little brothers.
When Texas 13-year-old Preston Pipkins needed a life-saving bone marrow transplant as he battled leukemia, his little brother Cameron, 7, was right there to step in.
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Preston was living the life of your average teenager and would often play basketball. But in September of last year, his health took a turn, and it began with some noticeable symptoms.
Preston's mother, Rachael Pipkins, told NBCDFW that Preston started losing his appetite and was tired more often. The symptoms lingered for two to three weeks and became hard to ignore when he had to be taken out of a basketball game.
"It was really hot outside and when I touched him and held onto him, he was really cold," Rachael Pipkins said to KXAS news.
Preston was taken to the hospital where doctors gave his family a life-altering diagnosis. He was diagnosed with acute myeloid leukemia, a form of cancer that starts in the blood-forming cells of the bone marrow, on Sept. 27, 2022.
Rachael said doctors told the family he would need a bone marrow transplant if he wanted to survive.
"Challenging is not even the correct word for it," Rachael Pipkins said to WFAA news.
A cancer diagnosis can be shocking, breathtaking, and intimidating. Those are just some emotions would-be cancer warriors and their families experience.
Being diagnosed with acute myeloid leukemia can be emotionally overwhelming, and patients and their loved ones are sure to have many questions about the disease and how it will affect the child.
One helpful suggestion for cancer warriors at the start of their cancer journeys is to learn more about the disease. Also asking your doctor additional questions and even seeking a second opinion can help ease the initial shock and anxiety associated with a new diagnosis.
"I think it's really important for them to be able to hear it multiple times, take notes," Dr. Heather Yeo, colorectal surgeon at Weill Cornell Medicine said.
What Is Leukemia?
According to the American Cancer Society, leukemia is a cancer of the early blood-forming cells. When these cells become leukemic, they stop maturing properly and grow out of control. Eventually, they spill into the bloodstream. Because they are essentially abnormal white blood cells, they prevent your blood from doing normal things like fighting infections, keeping your energy up and preventing excessive bleeding.
There are different types of leukemia that are classified based on how fast it grows and where the cancer originates. Depending on the type of leukemia, doctors will treat it accordingly.
The different types of leukemia include:
- Acute lymphocytic leukemia (ALL). Starts in the bone marrow where white blood cells are made and it's more common in children than adults.
- Acute myeloid leukemia (AML). Most common among older people.
- Chronic lymphocytic leukemia (CLL). A type of cancer that starts from white blood cells or lymphocytes in the bone marrow. CLL mostly impacts older adults.
- Chronic myeloid leukemia (CML). Starts in the blood-forming cells of the bone marrow and invades the blood.
- Chronic myelomonocytic leukemia (CMML). A type of cancer that starts in blood-forming cells of the bone marrow and invades the blood. CMML mostly impacts older adults.
"Leukemia is the most common cancer in children and teens, accounting for almost 1 out of 3 cancers," the American Cancer Society says.
Understanding Acute Myeloid Leukemia in Children
Childhood acute myeloid leukemia (AML) is a type of cancer where the bone marrow makes a large number of abnormal blood cells, according to the National Cancer Institute.
Cancers that are acute usually get worse quickly if they are left untreated. By contrast, cancers that are chronic usually progress slowly.
"Most of the time, this comes as an unwelcome surprise diagnosis," Dr. Gail Roboz, a medical oncologist at Weill Cornell Medicine with expertise in acute myeloid leukemia, tells SurvivorNet.
"Often, patients have no idea that leukemia is even anywhere on the radar. Sometimes patients actually have no symptoms at all and may be diagnosed in the course of a completely routine evaluation."
Acute Myeloid Leukemia Symptoms and Risk Factors in Children
Risk factors for childhood AML include:
- Having a sibling with leukemia
- Having a personal history of bone marrow failure
- Past treatment with chemotherapy or radiation therapy
- Having certain syndromes or inherited disorders including as: down syndrome and aplastic anemia (occurs when the body stops producing enough new blood cells)
More on Acute Myeloid Leukemia
Signs of AML typically include:
- Fever
- Night sweats
- Shortness of breath
- Weakness or tiredness
- Easy bleeding or bruising
- Pain or feeling of fullness below the ribs
- Painless lumps in the neck, underarm, stomach, groin or around the eyes
- Loss of appetite or weight loss
Acute Myeloid Leukemia Treatment
Treatment options for acute myeloid leukemia in children depend on the overall health, age, and ethnicity of the child. Other factors doctors consider include the number of white blood cells in the blood.
Most cases of AML have the following options available as treatment:
- chemotherapy
- radiation therapy
- stem cell transplant
- targeted therapy
- Watchful waiting
- Supportive Care
Brothers’ Shared Journey
One of the biggest challenges Preston had to overcome while battling AML was finding a match for the bone marrow transplant. Preston is biracial, with a white mom and Black dad. His racial makeup made it harder to find a match for the transplant.
According to "Be the Match", a national marrow donor program, the odds of finding a match based on ethnic background for people of color is lower than white people, which is 79%, according to 2021 data. Native Americans have a 60% chance of finding a match, Hispanic or Latino-Americans have a 48% chance, Asian-Americans have a 47% chance and Black or African Americans have just 29% chance of finding a match.
Washington Post reported, "African Americans have the most diverse genetics because of their ancestors have been around the longest and because intermixing with whites, Native Americans and Hispanics since Africans arrived in the Western Hemisphere."
Jeffrey Chell, co-founder of the Center for International Blood and Marrow Transplantation (CIBMTR), punctuated the point by adding, "If your ancestors were on two or three continents…it's going to be harder to find a match."
Luckily for Preston, he was able to look to family for a match. His younger brother Cameron matched perfectly to the relief of the entire family.
"We found out on the same day that he was a match, they told us there were no viable matches in the registry for Preston," Rachael Pipkins said.
The brothers underwent surgery in February and Preston was given his brother's stem cells so he could treat the acute myeloid leukemia.
"I told him he was a superhero because he gave me the bone marrow that I needed," Preston Pipkins said about his brother.
"I felt very grateful and joyful," Cameron said graciously as he and his older brother embraced in the hospital before finally preparing to go home.
"You saved me," Preston said to a smiling Cameron.
The Science Behind Bone Marrow Transplants
"As the patient if you've received your chemotherapy, and or your radiation, you're ready for your transplant," Dr. Caitlin Costello, a hematologist and medical oncologist at UC San Diego Health, tells the SurvivorNet family.
WATCH: What Are The Options For Patients When Acute Myeloid Leukemia.
Acute myeloid leukemia (AML) is a type of cancer in the bone marrow. Once a person has received an AML diagnosis, and went through chemotherapy or radiation, the next step is the bone marrow transplant. This is critical in the treatment process, seeing as a person's original bone marrow will be replaced by healthier bone marrow. While the procedure may sound frightening, Dr. Costello assures patients that it isn't as suspenseful as it appears.
"It's a procedure which we've spent the last many weeks and months building up to, and your nurse while you're in the hospital will bring over basically a bag of blood, and it feels and looks like nothing more than a blood transfusion," Dr. Costello says.
During the transplant, patients will be connected to an IV which will drip donor bone marrow into their system, and from there the bone marrow will enter into the body through the bloodstream. Patients will be in the hospital for two to four weeks after the transplant so they can be monitored while the bone marrow fully develops. There may be side effects from the transfusion such as significant fatigue, nausea, and a weakened immune system, but that's what the medical team is there for.
"What we will be seeing happen to patients is on their blood tests that we check daily we see that their bone marrow is shutting down," Dr. Costello says. "We see that their immune system is weakening, their bone marrow is no longer producing those immune system cells, their body is no longer producing the blood the literal gas in their tank and it's during this time that we're supporting you because we can keep your tank full, we can give you blood transfusions and platelet transfusions…as a means to keep you safe."
In addition to blood and platelet transfusions, physicians will give patients protective antibiotics in order to keep them safe while their immune system is weak, and the new bone marrow is growing.
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