Harrison McKinion: Putting Faith in Cancer Research
Our son Harrison was diagnosed with acute lymphoblastic leukemia (ALL) in December 2011. When 4 weeks of chemotherapy did not eliminate the leukemia from Harrison’s bone marrow, his doctors looked at the genome of the leukemia cells. They found an alteration recently detected in leukemia cells from other children whose ALL did not respond to chemotherapy. Harrison was the first child with ALL to have a drug targeted to the effects of the genomic alteration, the tyrosine-kinase inhibitor imatinib (Gleevec), added to his chemotherapy. It put him into complete remission. Although he has recently had a relapse of the leukemia in his central nervous system, Harrison’s doctors have turned to second-generation tyrosine-kinase inhibitors, and we are hoping they will help the way imatinib did.
Harrison’s diagnosis with ALL came just a few days after his 10th birthday. He had always been a very energetic child, constantly outside playing sports. But for about 2 months before the diagnosis, he hadn’t been feeling his usual self. Over that time, he gradually felt worse. Harrison became more and more lethargic, started having night sweats, and became very pale.
Thinking he had a virus, we took him to the pediatrician. The pediatrician sent us straight to the emergency room (ER) at Wake Med, telling us Harrison either had a virus or leukemia, and further tests were needed immediately to distinguish between the two.
A blood test in the ER confirmed that Harrison had leukemia, and he was transferred right away to North Carolina Children’s Hospital. Just 2 days later, he started the intensive induction chemotherapy that is standard treatment for pediatric ALL.
The goal of induction chemotherapy is to achieve complete remission, and so the drugs that they use are very strong. It was a really difficult time for the whole family, and the chemotherapy took its toll on Harrison’s body. About 2 weeks into the treatment, he had a stroke and multiple seizures. He was in the pediatric intensive care unit for 10 days, and we didn’t know if he would live.
After 4 weeks of chemotherapy, we found out there were almost as many leukemia cells in Harrison’s bone marrow as there had been when he was diagnosed. He was in the small percentage of patients who do not go into remission after induction chemotherapy. We were devastated.
Harrison’s doctors began looking for answers as to why he was not in remission. One thing they did was look at the genome of the leukemia cells. They found the cells contained a recently reported chromosomal translocation found in cases of pediatric ALL that did not respond to induction chemotherapy.
Harrison’s doctors contacted the researchers who had first reported the chromosomal translocation, and together they decided to add imatinib to the chemotherapy regimen because imatinib targets the effects of the chromosomal translocation.
About a week after starting imatinib, Harrison was in remission. The day we found out – January 24, 2012 – was amazing. We were very tense waiting for the test results, but the doctor came in and said, “We have a touchdown.” All the nurses, oncologists, and patients in the clinic erupted in cheers and clapping.
Harrison continued through the standard chemotherapy protocol for pediatric ALL, which ended in April 2015. Throughout that time and until the relapse in his central nervous system was discovered at the end of June [2016] he took imatinib once a day.
The doctors think the relapse occurred because imatinib does not penetrate into the central nervous system very well. So they switched him to dasatinib (Sprycel), a second-generation tyrosine-kinase inhibitor that penetrates the central nervous system better than imatinib. This drug knocked down the number of leukemia cells but did not eliminate all of them. As a result, Harrison has just finished a course of high-dose chemotherapy and another drug that targets the effects of the chromosomal translocation, nilotinib (Tasigna).
We are hoping that this plan will put Harrison into complete remission again and allow him to move on to the consolidation phase of treatment for his type of leukemia.
We are telling Harrison’s story because we are truly grateful for the research that led to imatinib and other drugs like it that have kept our son alive and have the potential to put him back into complete remission. His doctors told us if he had been diagnosed just 6 months earlier, he would not have survived because the research knowledge that led them to their treatment decisions would not have been there. With greater public and private support for research, we believe that more children will survive their cancers.