Stem Cell Transplant Gives Leukemia Patient a Second Chance at Life

Zayla Mitsdarffer’s mother refers to the day of her daughter’s blood stem cell transplant as her “re-birthday.” On July 20, 2007, following two years of intensive, but conventional treatment for an aggressive type of leukemia, six-year-old Zayla underwent a transplant with donated stem cells from one of her sisters.

“The stem cell transplant gave her a fresh start,” says her mother Chris. “It was like she was re-born.”

When Zayla was three years old, she was diagnosed with a particularly severe type of acute lymphoblastic leukemia (ALL). Cancer specialists at the University of Chicago Medicine Comer Children’s Hospital hoped that vigorous treatment with radiation and chemotherapy could cure the little girl. But just a few months before finishing her treatment, she relapsed.

Zayla was in the thirty percent of patients who do not respond to first-line therapy. Her physicians concluded a blood stem cell transplant was the best strategy for a cure.

Zayla and Dr. John Cunningham

John Cunningham, MD, an expert in stem cell transplantation and Philip Connell, MD, a specialist in radiotherapy for pediatric malignancies were also on the team treating Zayla.

Dr. Cunningham determined she was a candidate for allogeneic transplantation – the transplant of blood stem cells from a related or unrelated donor. In Zayla’s case, both of her older sisters were perfect matches. (The cord blood from twin sisters who died at birth was also a match). Her oldest sister, Shelby, was chosen because she could provide the largest number of stem cells for the transplant.

Prior to transplantation, Zayla required conditioning therapy -- a combination of radiation therapy and chemotherapy to wipe out all of the leukemia cells in her blood. Drs. Connell and Cunningham coordinated all of these treatments.

Dr. Philip Connell, Zayla's radiation oncologist

“In some major centers, patients have to travel in an ambulance from one hospital to another for the radiation portion of treatment,” says Chris. “We were happy that Zayla could get all her therapy in one place. It was so easy.”

The transplantation of new healthy stem cells was a simple, quick and painless procedure. Just hours after removing the donated cells from Shelby, they were infused through Zayla’s central line.

“These new blood stem cells restored the blood-forming cells in Zayla’s bone marrow and created a new immune system for her,” says Dr. Cunningham. “In addition to replacing the bone marrow, the small white cells (lymphocytes) of donor origin attacked any remaining leukemia in her system.” (See related story below.)

Because the first 100 days post-transplant are always critical for increased risk of complications, Zayla’s doctors monitored her carefully through her recovery process. After a few weeks in the hospital, the little girl and family members moved to the nearby Ronald McDonald House for an additional month so she could easily make daily trips to Comer Children's Hospital for observation.

“I can’t say enough about how phenomenal the Ronald McDonald House was for us,” says Chris. “Our family could be together in a ‘home away from home’ during the time we still needed to go to the hospital for frequent treatments.”

Today, Zayla’s bone marrow and immune system are functioning normally. The Mitsdarffer family will celebrate her second “re-birthday” in July 2009. She is finishing up second grade and anxious to play softball this spring. “You can’t slow her down now,” says her mom. “She wants to try everything because she missed out on so much during her years fighting cancer.”

Graft vs. Leukemia Clinical Trial to Open This Year

Researchers at the University of Chicago will initiate a trial, starting summer 2009, testing the effectiveness of giving stem cell transplant patients extra lymphocytes from their donor after transplant.

When donated stem cells are given to a patient during transplant, they not only begin making healthy stem cells, they also have the potential to generate lymphocytes that strike and destroy any remaining leukemia cells.

“We want to see if this 'graft vs. leukemia' phenomenon can be fortified by giving the patient extra healthy lymphocytes post-transplant,” says Dr. Cunningham. “Since relapse is always a concern, this could be another weapon in the battle against leukemia.”

Zayla's Treatment Team

Philip Connell, MD
John Cunningham, MD

Autumn 2007