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Published on January 30, 2019

Kristin VanLaecken and Kelly McCaul, MD

After Leukemia: Remission and Returning to Life

During the nearly two years since Kristin VanLaecken got her bone marrow transplant she’s had some ups and downs — hospitalizations, blood transfusions and the fear of transplant rejection.

But these are the challenges common for a person on the road to remission after being diagnosed with acute lymphoblastic leukemia with the Philadelphia chromosome. Simply put, VanLaecken has an aggressive form of leukemia paired with a genetic abnormality that makes transplant necessary for survival, said Kelly McCaul, MD, Avera Medical Group hematologist.

It’s usually about two years before a transplant patient will start feeling normal, and VanLaecken is still short of that goal.

“I’m feeling so much better now. It’s a prayer every day – where do you want me to go today?” she said. “I just see where the day takes me. I still keep things day to day because planning can still be overwhelming.”

The Branches of Cancer Treatment

McCaul likens treatment of leukemia to a tree. You start with a trunk and as treatment progresses you develop branches this way and that. Every tree is different.

“Treatment is never linear and everything we do is complicated,” McCaul said. “There are many things that can happen and that’s why we require the degree of support and training we have. We have built that level of expertise over 18 years at Avera.”

Years ago, long-term survival for this aggressive cancer was less than 10 percent. Advances in transplant methods and new drugs have allowed for big strides, McCaul said.

There are hundreds of complications that can occur from the aggressive treatments leukemia demands. Issues can range from minor infections to other cancers that occur due to the changes in the immune system.

VanLaecken’s branches started sprouting in January 2017 when she was diagnosed and immediately drove to the hospital to start chemotherapy to decrease her white blood cell count and start getting rid of the disease.

She spent months on and off in the hospital, including the days after she received her bone marrow transplant from an unknown donor.

Getting Back to Normal

VanLaecken, who lives in Watertown with her husband and five kids, focused on action during treatment.

“We just did what we needed to do,” she said. “I’m happy they have the know-how to do all these things because the science behind it is mind blowing.”

Since the transplant she has returned to the hospital for fevers and for a time needed frequent blood transfusions because her hemoglobin was low.

That caused her iron levels to spike, so now she must frequently give blood during her clinic visits until her iron levels get back to normal.

During all this she also went on more medications because her team found she had a case of graft versus host disease in her liver. This means her body was recognizing her new stem cells as foreign and was attacking them, which could cause the transplant to fail and disease to return.

“The day they told me I had that in my liver I was more upset than when they told me I had cancer,” she said.

VanLaecken is almost feeling normal again, though tired. She prefaces that with a chuckle because with five kids tired comes with the territory.

‘We Want to Return Her to Life’

That doesn’t mean treatment will end anytime soon. She’ll continue to see McCaul and his team for many years, though less often over time. They will continue to manage any other issues that occur due to the treatment, including continued treatment for her graft versus host disease.

She shows no sign of leukemia, making recurrence less likely. That means she’s in remission.

“That’s why we do this,” McCaul said. “We want to return her to her life so she can continue to take care of her children and be a productive member of society. Kristin is doing fantastic.”

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