Devon and Leah Still Win ESPY Jimmy V. Perseverance Award

Cincinati Bengals defensive tackle Devon Still and his 5-yr.-old daughter Leah have won the Jimmy V. Perseverance Award for Leah’s brave battle with cancer. The award is named after the legendary North Carolina State basketball coach Jim Valvano who inspired many with his emotional speech at the 1993 ESPY awards while fighting his own cancer battle. That speech included his now famous words: “Don’t Give Up . . . Don’t Ever Give Up!”®.

Celebrity Diagnosis readers know that Leah Still was diagnosed with Stage 4 neuroblastoma in June 2014. Doctors gave her a 50-50 chance of survival.  After 4 rounds of chemotherapy to shrink her tumors, Leah underwent successful surgery at Children’s Hospital in Philadelphia to remove a tumor from her abdomen. She was declared to be in remission in March.

But Leah’s fight was not over quite yet. To ensure the cancer wouldn’t come back, Leah would undergo a stem cell transplant in May 2015. During the lengthy hospital stay, high doses of chemotherapy would essentially wipe out her immune system. Then doctors would replace those diseased cells with healthy new immune cells.

Leah had one serious complication during stem cell transplant, a potentially fatal inflammation of the blood vessels in the liver called veno-occlusive disease (VOD). Inflammation leads to swelling of blood vessels, blocking the flow of blood in the liver. The liver isn’t able to properly perform one of its important functions- removing toxins, drugs, or other waste products from the blood.

Leah recovered from VOD and was able to go home on June 22.

At Tuesday night’s  televised ESPY Awards event, Devon Still was introduced to the audience by their friend LeBron James. Unfortunately, Leah was unable to attend the event live, but did make “an appearance” on the big screen to thank everybody. Leah is still unable to be around crowds of people because her immune system is not yet working fully.

What are blood stem cells?

09.24.cancerBone marrow is the soft, sponge-like material found inside bones. It contains immature cells known as hematopoietic or blood-forming stem cells. Hematopoietic stem cells divide to form more blood-forming stem cells, or they mature into one of three types of blood cells:

  • white blood cells, which fight infection;
  • red blood cells, which carry oxygen; and
  • platelets, which help the blood to clot.

Most hematopoietic stem cells are found in the bone marrow, but some cells, called peripheral blood stem cells (PBSCs), are found in the bloodstream. Blood in the umbilical cord also contains hematopoietic stem cells. Cells from any of these sources can be used in transplants.

What is a stem cell transplant?

A stem cell transplant is a procedure that restores stem cells that have been destroyed by high doses of chemotherapy and/or radiation therapy. There are three types of transplants:

  • In autologous transplants, patients receive their own stem cells.
  • In syngeneic transplants, patients receive stem cells from their identical twin.
  • In allogeneic transplants, patients receive stem cells from their brother, sister, or parent. A person who is not related to the patient (an unrelated donor) also may be used.

A stem cell transplant may be used to treat cancer patients so that it is possible for patients to receive very high doses of chemotherapy and/or radiation therapy. It is most frequently used in the treatment of leukemia and lymphoma, but is also used in patients with neuroblastoma and multiple myeloma.

How are stem cells obtained for transplantation?

09.24.cancer1The stem cells used in a transplant come from the bloodstream. A process called apheresis is used to obtain stem cells for transplantation.

A stem cell donor may be given a medication for 4 or 5 days before the procedure to increase the number of stem cells released into the bloodstream.

In apheresis, donor blood is removed through a large vein. The blood goes through a special machine that is able to remove the stem cells. The blood is then returned to the donor and the collected cells are stored. The procedure typically takes 4 to 6 hours. The stem cells are then frozen until they are given to the recipient.

How is the cancer patient treated?

The patient who is to undergo stem cell transplant will receive high doses of chemotherapy and/or radiation therapy until the bone marrow is completely empty of blood and stem cells.

09.24.cancer2The patient is moved into the hospital for the hospital for an extended period of time during which he/she will be given the previously collected stem cells through a large vein or chemotherapy port.

To prevent problems, the donor’s stem cells should match yours as closely as possible. Donors and recipients are matched through a blood test called HLA tissue typing.

After entering the bloodstream, the stem cells travel to the bone marrow, where they begin to produce new white blood cells, red blood cells, and platelets in a process known as “engraftment.” Engraftment usually occurs within about 2 to 4 weeks after transplantation. Doctors monitor it by checking blood counts on a frequent basis.

Complete recovery of immune function takes much longer, however—up to several months for autologous transplant recipients and 1 to 2 years for patients receiving allogeneic or syngeneic transplants. Doctors evaluate the results of various blood tests to confirm that new blood cells are being produced and that the cancer has not returned. Bone marrow aspiration (the removal of a small sample of bone marrow through a needle for examination under a microscope) can also help doctors determine how well the new marrow is working.

What are the possible side effects of stem cell transplant?

The major risk of both treatments is an increased susceptibility to infection and bleeding as a result of the high-dose cancer treatment. Doctors may give the patient antibiotics to prevent or treat infection. They may also give the patient transfusions of platelets to prevent bleeding and red blood cells to treat anemia. Patients who undergo stem cell transplant may experience short-term side effects such as nausea, vomiting, fatigue, loss of appetite, mouth sores, hair loss, and skin reactions.

Other, potentially serious, problems after stem cell transplant include:

  • Graft-versus-host disease: Graft-versus-host disease can occur when white blood cells from the donor (the graft) recognize cells in the body (the host) as foreign and attack them. This problem can cause damage to the skin, liver, intestines, and many other organs. It can occur a few weeks after the transplant or much later. Graft-versus-host disease can be treated with steroids or other drugs that suppress your immune system.
  • Veno-occlusive disease (VOD): See above
  • Graft failure: Grafts fail when the body does not accept the new stem cells. The new cells do not colonize the bone marrow or produce new blood cells. This most commonly occurs if the donor and patients do not match as closely as they should.

Source: National Cancer Institute

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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