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Pathways to Discovery: Winter 2012

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Novel Treatment Approach Helps Teen Swimmer Dive Back in Pool

Survival rates in AML are certainly better than they were years ago, but we are always working to improve them.
—Jennifer McNeer, MD

Kris Egebrecht knew something was wrong when Brandon, her teen who loves to swim, could not get out of bed.

"I slept for 15 hours a day for 3 days straight," Brandon said.

Kris took him to an urgent care clinic near their home in Northwest Indiana and was convinced a blood test would reveal a diagnosis of mononucleosis, a viral illness common in teens. Instead, Brandon tested positive for acute myeloid leukemia (AML).

While Kris grappled with what she called her "worst nightmare," Brandon's primary care physician set the wheels in motion for Brandon's treatment. With an aggressive disease like AML, time is of the essence.

Brandon's pediatric oncologist referred him to UChicago's Comer Children's Hospital, where Brandon was diagnosed with a genetic subtype of AML that was first described at UChicago in 1983 by Michelle M. Le Beau, PhD, and colleagues.

Brandon was enrolled in an innovative clinical trial affiliated with St. Jude Children's Research Hospital in Memphis, Tenn., that utilized an aggressive treatment plan. The drug clofarabine, which is effective in patients with relapsed AML, was administered as the first cycle of induction therapy, followed by four cycles of standard chemotherapy.

"The goal of this study is to achieve better remission rates by using this more intense drug as part of the initial therapy for newly diagnosed patients," explained Jennifer McNeer, MD, assistant professor of pediatrics.

Overcoming Setbacks
Brandon's first treatment was the most challenging. He developed tumor lysis syndrome, which occurs when chemotherapy very quickly breaks down leukemic cells, explained Dr. McNeer. It caused Brandon's kidneys and lungs to fail. Dr.McNeer said Brandon's care team worked together to support him until his kidneys resumed their normal function.

Kris said she was impressed with how Brandon's care team explained every step of the treatment to the family, "They answered questions before I even knew I had questions."

Brandon's treatment ended early because the study protocol showed that four cycles of chemotherapy achieved the same results as five, according to Dr. McNeer.

"Survival rates in AML are certainly better than they were years ago, but we are always working to improve them," she said. "It's great we were able to offer Brandon a unique treatment protocol."

Looking Ahead
Brandon was diagnosed with leukemia in April 2011. By August, his treatment was completed and he began his junior year of high school.

"I've grown a lot from this experience," Brandon said. "It has definitely changed my perspective." For now, his focus includes getting back in the pool and earning a college scholarship for swimming.


pediatric leukemia patient