Children Cancer Stories by Rukh Yusuf - Blog # 13
It is difficult to call “Warrior” or even
“Survivor” to a two-year-old Zainab who is too young to understand her disease
and condition. Zainab is the first child of her parents and belongs to middle
class family of Lala Musa.
Few months ago, Zainab’s mother felt mumps and
swelling on her face and neck. The parents consulted a physician in Lala Musa
and Zainab got better after some initial treatment. After few days, she
developed swelling on her arm at canula site.
She was examined by a couple of pediatricians
one after another in her city, but nothing was diagnosed and her condition did
not improve as well. The Child Specialist asked for CBC and blood culture, CBC
showed raised WBCs and the physician suspected infection or some malignancy.
She was referred to pediatric hospital in Lahore. Zainab was diagnosed as case
of T-cell ALL after few tests at a
hospital in Lahore.
T-cell acute lymphoblastic leukemia (T-ALL) is aggressive and progresses
quickly. It affects the lymphoid-cell-producing stem cells, in particular a
type of white blood cell called T lymphocytes as opposed to acute lymphoblastic
leukemia (ALL) which commonly affects B lymphocytes.
In most cases of T-Cell ALL there is no obvious cause, and it is not
passed on from a parent to a child (inherited). T-ALL is most common in
children and T-ALL affects males more than females at all ages.
Symptoms may include anemia, weakness, tiredness, shortness of breath, palpitations. Infections are more
frequent, more severe, and last longer. Fever, malaise (general feeling of
illness) and sweats, purpura (small bruises in skin), nosebleeds and bleeding gums are also common symptoms. Other important signs
and symptoms include swollen lymph nodes in the middle part of the chest
(mediastinum) which may affect breathing or the circulation.
Diagnosis usually involves blood counts, bone marrow biopsy and flow
Cytometry. Staging is not used for T-ALL,
because it spreads throughout the body when first diagnosed. Most cases of
T-ALL are classed as high risk. With appropriate treatment, they have a very
good chance of successful treatment.
Virtually all patients with T-ALL should start treatment immediately. The
main ways in which leukemia is treated are chemotherapy, steroids, and radiation therapy. Radiation therapy is usually given
only as part of a stem cell transplant in T-ALL. Younger, suitable patients may
be given a stem cell transplant (bone marrow transplant). This is done using
healthy stem cells from a donor. Transplant is usually done for T-ALL if
chemotherapy does not cure the disease.
Zainab received chemotherapy and completed her induction successfully; her
post induction report was satisfactory. The parents were satisfied about
treatment and relaxed to see progress. But their relief did not last longer. To
their dismay, after couple of weeks she again developed fever and swelling and
was admitted again. Treatment and diagnostic tests were done, and it revealed that
her disease had relapsed. Doctors said,
her further treatment was not possible as patients
with relapsed T-cell acute lymphoblastic leukemia (T-ALL) have limited
therapeutic options and the disease had poor prognosis.
The news was disheartening for a mother whose only child is suffering
with such a disease with no or minimal hope for cure. Zainab is on palliative treatment only; her
parents and family are approaching different experts to find some solution for
the sickness of their little angel with tears and hope in their eyes. Poor Zainab is not in a position to know
about her current and future life. She is living as happily as she can, in her
innocence.
There is
some development in Zainab’s treatment, some new finding have been found in
more diagnostic tests. I will update about this when the information is
completed.
We all pray for Zainab’s recovery and ease
for her family. Aameen
Note: names have been changed to
protect identity.
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