Teen Looks to the Future After Successful Bone Marrow Transplant

On Sunday, May 30, 108 days after undergoing a bone marrow transplant for treatment of leukemia, 17-year-old Jenna McKeown of Naperville, IL, celebrated her graduation from Benet Academy.

The event provided a pleasant finish to a tough senior year. On October 28, 2009, McKeown was diagnosed with an aggressive form of acute myeloid leukemia (AML).

AML is a life-threatening form of bone marrow cancer that affects the production of white blood cells. Jenna's leukemia was a type of AML known as acute monocytic leukemia, often called M5. It involves the overproduction of certain types of white blood cells.

This form of AML has many symptoms of general AML -- such as fatigue, unusual bleeding and bruising, and high risk of infections -- but also has some special features, including blood clots that can cause multiple organ failure if not treated promptly.

"Luckily, Jenna was promptly diagnosed and began treatment quickly," said her physician, John Cunningham, MD, chief of pediatric hematology/oncology at Comer Children's Hospital at the University of Chicago and an internationally known expert on childhood cancers and blood diseases.

Her leukemia was first diagnosed by Charles Rubin, MD, associate professor of pediatrics at the University of Chicago, who saw her at Edward Hospital, in Naperville. He arranged for her to meet with Cunningham at Comer.

A cytopathologist at Comer determined that Jenna had a rare version of M5, caused by an unusual exchange of genes between chromosomes 10 and 11. This exchange, known as a 10;11 translocation, meant she would benefit from aggressive therapy.

Treatment for any type of AML is a lengthy process. It begins with chemotherapy aimed at inducing a remission of the disease. Jenna went through three rounds of induction therapy, using a combination of anti-cancer drugs. This lasted through the Christmas holidays and into the new year.

"It was really hard," said Jenna, "but you learn to deal with it. It gets easier as you go. It helped that I had lots of support from my family and friends and neighbors, plus from my school and my church."

To prevent the disease from recurring, a significant risk for patients with the 10;11 translocation, Cunningham and colleagues at the University of Chicago advised "consolidation therapy," which involves more chemotherapy, at higher doses, followed by a bone marrow or "hematopoietic stem cell" transplant.

Although high doses of chemotherapy can eradicate any remaining traces of her cancer, the medicines kill bone marrow cells, required for life. To replace her missing marrow, Jenna needed an infusion of bone marrow stem cells once the chemotherapy was completed. The transplanted cells replace the lost bone marrow and take over the job of making new blood cells.

The challenge for Jenna was finding a compatible source of stem cells. Usually a sibling acts as the donor, but often brothers and sisters are not sufficiently identical, so for Jenna the physicians turned to the National Marrow Donor Registry to find a genetically similar unrelated donor. The McKeowns were fortunate in finding matching donor quickly and on February 4, Jenna started the high-dose chemo and marrow-transplant regimen, which kept her in Comer Children's Hospital at the University of Chicago for a month.

"That was the roughest part," said her father, Jerry McKeown. She tolerated the rigorous treatment well, however, and was able to leave the hospital in March. She continues to recover and regain her strength at home. Jenna returned to school just this week.

Luckily, she has always been a "strong student, a go-getter," said her father. She was "ahead of schedule in the fall, before this all began, and had already submitted her college applications. The high school helped her through treatment and recovery," he said, "allowing her to focus on her health." She needed only one more English credit, which she recently completed.

Although she missed much of senior year, every college she applied to accepted her. She plans to attend St Mary's College in Notre Dame, IN, this fall.

"I was already interested in medicine, especially nursing, and in pediatric oncology," she said, "but now I'm pretty sure that's what I want to do."

"It has become her calling," said her father. "What child would not want to have a nurse who went through what they were going though?"