Acute Lymphoblastic Leukemia: Morgan’s Story

Morgan has always been an active child who likes to play hard. Her parents, Pamela and Derek, were used to seeing bumps and bruises on their 4-year-old’s shins from the normal playground spills. But one weekend they noticed a different kind of bruising a couple of days after she had fallen on some stairs. These speckled bruises were spread across her body and appeared in places where she hadn’t made an impact during her fall.

They made an appointment with their pediatrician at Children’s Hospital of Philadelphia (CHOP) Primary Care in Mt. Laurel, NJ. As she examined Morgan, their doctor agreed that the bruises looked concerning, and asked the parents to bring her to a lab for blood work.

They decided to bring Morgan to CHOP’s Main Campus for the tests. They drove straight from the pediatrician’s office to the Emergency Department in University City, Philadelphia.

“We knew within an hour that she had leukemia,” remembers Pamela. “They brought us up to the Oncology Unit and within a couple of hours she was getting a blood transfusion and a platelet transfusion.”

Treatment started right away

Over the next couple of days, the family got a more precise diagnosis of her condition: B-cell acute lymphoblastic leukemia (ALL). This is the most common form of leukemia found in children, accounting for about 25 percent of all pediatric cancers. It also has one of the highest cure rates of all childhood cancers.

The family’s life changed dramatically that week. Instead of going back to preschool, Morgan began an intensive regimen of chemotherapy. For the next few months, she would need to avoid contact with other children to reduce the risk of catching any kind of infection. Her platelet counts were often low as a result of the leukemia, and the chemotherapy sometimes weakened her immune system.

When she needed inpatient chemotherapy, Morgan was seen by rotating members of the Cancer Center’s medical team. When she developed a fever, she was rushed to the Emergency Department as part of the Hospital’s fever protocol.

“Morgan made friends with all the nurses and staff on the oncology floor,” says Pamela. “She loves the child life specialists who run activities for the kids, like art and music therapy. She just has a blast. In fact, there were two occasions when we were sent home from the ER instead of being admitted and Morgan was genuinely disappointed she wouldn’t get to play with her child life friends on the third floor.”

For regular appointments, the family takes Morgan to CHOP’s Specialty Care & Surgery Center in Voorhees, NJ, where she is seen by oncologist Nicholas Evageliou, MD. “We feel like we are part of a family at Voorhees Specialty Care,” says Pamela. “Every one of the staff members knows Morgan and how to interact with her no matter how she is feeling that day — cheerful, hungry, sick and even feisty. The staff empowers Morgan to make decisions whenever possible so she feels in control and a part of the treatment process.”

Morgan went through the standard phases of treatment: induction, consolidation, interim maintenance and delayed intensification, and is now in the maintenance phase. For the next two years, she will continue chemotherapy with daily oral doses and monthly steroid pulses and intravenous and/or spinal injections of chemotherapy.

Looking to the future

Her parents kept Morgan out of preschool for nine months during the intensive stages of her treatment. Now that she is moving to oral medication and is in remission, she’s about to return to school and is very much looking forward to it. In the fall, she’ll start kindergarten.

Morgan loves to play outside, kick a soccer ball with her parents and ride her bike. She also loves to dance, swim and even food shop with her dad on Sunday mornings. That’s all possible again now that she’s in the maintenance phase of her treatment.

“She has so much energy and she’s feeling so good,” says Pamela. “Looking at her, aside from her bald head, you would never know that she has been through over 200 doses of chemotherapy, 227 needle pokes, 16 spinal taps, 10 blood and platelet transfusions and 38 nights in the hospital. She’s happy, lively and feeling great. She is an amazing little lady.”