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Leukemia Diagnosis During Pregnancy

Designers to decide

October 22, 2019

Tytan Mayer just might be a hero. Still shy of his first birthday, he has big blue eyes and a cuddly body that may seem more sweet and gentle than strong. But his family knows Tytan helped save his mother’s life before he was even born.

In December 2017, Whitney Mayer, 32, was elated to learn she was pregnant with her 4th child. But abnormal bloodwork at a routine screening and sonogram turned happiness into concern.

“I’d been working 12-hour days,” says Whitney, a hairstylist from Wamego, Kansas. “I worked out every day. I took care of a family with 3 active kids. I was a bit fatigued, but didn’t think it was anything out of the norm of a busy life and a pregnancy.”

Riding a roller coaster

Whitney’s January bloodwork showed no improvement. She had severe anemia and immature white cells in her blood. She was referred to a hematologist/oncologist in Manhattan, Kansas. He performed a thorough evaluation and ordered monthly bloodwork. While something was off, the tests revealed no disease. He continued to monitor her closely. At the end of March, Whitney’s labs “took a nosedive,” she says. She needed her 1st blood transfusion, and her doctor recommended a bone marrow biopsy.

“This was the beginning of my roller coaster ride,” Whitney says. “The next 2 days felt like years. We waited on pins and needles and had too much time to idle and ask ourselves, ‘What if?’”

Whitney’s biopsy was sent for evaluation. Days later, she learned the results were considered inconclusive. Briefly, she and her husband, Keith, felt relief, but it was quickly followed by confusion. “We thought, ‘If not blood cancer, then what?’”

Pursuing answers and a leukemia diagnosis

Whitney’s local doctor continued to seek answers. He called hematologist/oncologist Abdulraheem Yacoub, MD, at The University of Kansas Cancer Center, 1 of just 71 National Cancer Institute-designated cancer centers in the country.

“I never needed to know much about the medical field before this, but it made complete sense to me that doctors would consult, ask for help and lean on each other to get answers,” Whitney says. “This would only help everyone involved.”

Whitney and Keith made the 2-hour drive from Wamego to Kansas City for a full physical and evaluation. They learned about possible causes of the unusual bloodwork, including autoimmune conditions or pregnancy complications.

“Dr. Yacoub didn’t immediately find anything too far out of the norm, but said a few of my numbers just seemed a little off,” Whitney says. “He said he would test for everything possible and leave absolutely no stone unturned.”

While concerned about Whitney’s health, the Mayers also experienced joy during this visit. They met with maternal-fetal medicine specialist Marc Parrish, DO. An exam revealed their unborn baby was measuring right on target and appeared picture perfect.

“Rejoicing over our healthy baby began!” Whitney says. “We nicknamed him Baby Hulk.”

This happiness was a clear high on the Mayers’ roller coaster ride, but a downward plunge followed. Whitney received another bone marrow biopsy, a chest X-ray and an echocardiogram.

“I still didn’t think they were going to find anything,” she says. “I still thought I would be that 1-in-a-million girl who gets some rare pregnancy thing.”

But she wasn’t.

“I made one of the most difficult phone calls I’ve ever had to make,” says Dr. Yacoub. “I called Whitney and told her to sit down. We had a diagnosis. I told her she had acute myeloid leukemia and she needed to pack a bag for at least 30 days. While this disease has a high cure rate among young people, it is a medical emergency that requires immediate treatment.”

“This was the crash moment,” says Whitney. “I called my husband. I had to tell my 12- and 14-year-old sons to believe in me and don’t search the internet for anything. I told my 2½-year-old daughter she would be getting special sleepovers with my sisters. There were so many feelings I cannot describe, but all along, always on my mind, was the precious cargo I was carrying, my baby!”

Comprehensive approach to leukemia treatment

On their way to The University of Kansas Hospital, Whitney and Keith embraced a happy distraction, brainstorming baby names.

“Who would have known until you live it that chemotherapy while pregnant is a thing?” Whitney says. “That night, the resident physician explained to us how fast things would move.”

Whitney and Keith met with a number of specialists who would contribute to Whitney’s and the baby’s care. These included leading experts in oncology, blood and marrow transplantation and maternal-fetal medicine.

“These doctors came together so naturally, answering my 5 million questions about the cancer, about my unborn child, and about both together,” Whitney says. “I felt complete trust and reassurance in my care team.”

She immediately began chemotherapy. Her growing baby was closely monitored and showed no signs of being underweight or anemic, the common concerns associated with chemotherapy during pregnancy. The treatment did its job, but genetic testing revealed a mutation that put Whitney at high risk for the cancer to return. Her doctors recommended a bone marrow transplant to promote a long-lasting remission.

Whitney’s large family of 8 brothers and 9 sisters provided high hope that a suitable marrow donor could quickly be found. Indeed, 2 brothers matched perfectly. The younger of the 2, Shane, stepped forward.

Following the course of chemotherapy, Whitney returned home to her family for 8 precious days.

“It’s so easy to get sidetracked in the life we live,” she says. “It’s so easy to forget what is truly important. Cancer has taught me a new meaning of what living really is, and that’s what we did in those 8 days home.”

Joys and challenges

Whitney returned to the hospital for additional chemotherapy. She was scheduled to receive her final treatment at midnight on June 1, 2018. But, Baby Hulk had a different idea.

“My water broke!” Whitney says, recalling the surprise. “I can’t describe the feelings we all had at this moment. And I can’t describe how my doctors came together. The oncology doctors don’t do baby stuff, and the OB doctors don’t do cancer, but together, they made absolutely the perfect team.”

At 5:04 a.m., Whitney and Keith welcomed a healthy, 4 pound., 9 oz., baby boy into the world. And Tytan Jhett couldn’t have chosen a more perfect arrival time.

“Had he arrived 3 days earlier, I would have been 2 hours away from the hospital, and I would have missed important chemotherapy,” Whitney says. “Had he arrived a week later, I would have faced a much more complicated and dangerous childbirth due to low platelets and white blood cell count. This was a true miracle. I delivered a perfect baby, experienced a precious minute of skin-to-skin contact, and received my needed last chemo treatment only 12 hours later than planned.”

Whitney enjoyed a respite at home of almost a month. She then returned to Kansas City for outpatient chemotherapy to prepare for her transplant.

“Leaving behind 4 children, including a 6-week-old baby, is something I can’t explain,” Whitney says. “I focused on the fact that I was alive and able to fight and thankful for the medical care I was receiving.”

Another hurdle

On July 25, Whitney received her bone marrow transplant. Specialists Sunil Abhyankar, MD, and Anurag Singh, MD, led this aspect of her care. While the treatment offers lifesaving potential, it is not without challenges. Whitney experienced nausea, fatigue and painful mouth sores.

“Those days were rough, some of the hardest of my life,” she says. “But they brought my new start, my second chance.”

Photos and videos of her kids, encouragement and pep talks from her nurses, and even pick-me-up muffins from Dr. Yacoub saw Whitney through.

Once discharged from the hospital, Whitney settled into a rented apartment and faced 100 days of minimal contact from family or friends. Her new immune system needed time to grow and build strength, and until it did, she was highly susceptible to illness. But one important exception gave her focus.

“I was able to be reunited with my baby,” she says. “Our immune systems were the same! He was a huge comfort and help to me during those long days away. He was a physical reminder to me to get my exercise, to eat well.”

Homecoming

The 100 days passed, and Whitney grew stronger. Her homecoming was as joyful as she knew it would be. She rejoined her husband and children, the tiniest of whom had been the key to discovering the dangerous disease Whitney battled and beat.

“We are so pleased to see Whitney home with her family again,” says Dr. Yacoub. “The combination of collaboration with her local doctors, the expertise of a multidisciplinary team at a leading health system and cancer center, and the resources available to enable accurate diagnosis and comprehensive treatment all made this wonderful outcome possible. Positive attitude is half the battle, and Whitney brought that.”

“These doctors were the answer to my daily prayers,” Whitney adds. “They found the problem, set a plan and helped me conquer it. They create stories with happy endings. I see it in my children’s eyes each day when they get to wake up to me still with them. For their expertise, for their advice and for their hearts, I say, ‘God bless you.'"

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