Why?

After she came home from the first hospital stay- in too much pain to smile :(

WHY???

That’s the second most common question I get from people. 

Why was she in so much pain that she couldn’t walk? Why did this happen to her? 

First let’s start off with WHAT? What type of leukemia does Kaylee have?

Kaylee has Standard Risk Pre B Cell Acute lymphoblastic leukemia (ALL). 

• Standard Risk- There are three levels of “risk” that doctors use to determine prognosis. When she had a bone marrow biopsy to determine what type of leukemia she has, the doctors also took a sample to look at the genetics of her leukemia (because everyone is different). She has high hyperdiploidy, which is associated with a low white cell count. Therefor, she has “unfavorable” genetics which increased her risk from “low” to “standard”. Fortunately, her prognosis is still VERY good. 

• Pre B Cell- (From Wikipedia)- A Pre-B cell is a precursor to the development of B cells. Certain leukemias/lymphomas are associated with immature B cells, and observing pre-B cell populations can be useful in the identification of these conditions.

• Acute Lymphoblastic Leukemia- (from Wikipedia) Acute lymphoblastic leukemia (ALL) is a form of leukemia, or cancer of the white blood cells characterized by excess lymphoblasts. Malignant, immature white blood cells continuously multiply and are overproduced in the bone marrow. ALL causes damage and death by crowding out normal cells in the bone marrow, and by spreading (infiltrating) to other organs. ALL is most common in childhood with a peak incidence at 2–5 years of age, and another peak in old age. The overall cure rate in children is about 80%, and about 45%-60% of adults have long-term disease-free survival.

• Acute refers to the relatively short time course of the disease (being fatal in as little as a few weeks if left untreated) to differentiate it from the very different disease of chronic lymphocytic leukemia, which has a potential time course of many years. It is interchangeably referred to as Lymphocytic or Lymphoblastic. This refers to the cells that are involved, which if they were normal would be referred to as lymphocytes but are seen in this disease in a relatively immature (also termed 'blast') state.

Now, for the WHY-

Why did she go from “normal” to so sick so quickly?

• That all has to do with the “Acute” nature of the disease. It’s quite common to be healthy one day and bed ridden the next. 

Why was she in so much pain?

• Leukemia is basically cancer of the bone marrow/blood. When the leukemia cells began dividing so quickly, they caused extreme pressure in her bones, which left her unable to walk.

Why Kaylee? (And this is the one that we asked ourselves over and over and over again)

• There is no good explanation, but (as we were told over and over and over again in the hospital) nothing we did, or didn’t do, caused her leukemia. Doctors have found that there is a genetic predisposition in certain kids for leukemia. They can examine 10000 babies when they’re born, and 100 might have the “trigger”. Of those 100, only one may actually go on and actually be diagnosed with it. Knowing that one of our children obviously had the predisposition, means that all three of our children have it, which gives them a very slightly increased chance of also having leukemia. (From 1% to 2%)