Leukemia is a cancer of the bone marrow and blood, one characterized by an uncontrolled accumulation of blood cells. According to the Leukemia & Lymphoma Society Web site, almost 45,000 cases of leukemia will be diagnosed in the United States in 2007.
In general, it strikes 10 adults to every one child (ages 0-19). About one in three cancers in children ages 0 to 14 are leukemia. The most common form among children under 19 years old is Acute Lymphocytic Leukemia (ALL).
Survival rates have increased substantially since 1969, when Kim Hill's condition was first identified. In 1960-63, when compared to a person without leukemia, a patient had a 14 percent chance of living 5 years. Fifteen years later, that rate had improved to 35 percent, according to the Web site.
Assuming doctors treat the disease early, Dr. Audrey Evans, of the Children's Hospital of Philadelphia, says that "we now do cure 80 percent of what walks through our door."
It's how they treat the illness that also has evolved significantly. Hill was receiving radiation and chemotherapy along with spinal taps, a harsh regimen that had a singular goal: Keep the patient alive. Since then, doctors have learned much more about how to accomplish the same goals without the lethal combo of practices that caused such searing pain. It's believed that all but eliminating the radiation and reducing the chemo, for instance, have cut down on the second cancers like the one that has afflicted Hill.
"One thing that has evolved is that we are able to look more carefully at the type of leukemias or the cancers and define what's good and what's bad," Evans said. "We can separate our children that we can treat a little less vigorously and still be successful so they don't have the side effects of treatment."
She adds that the ones who 10 years ago might not have survived can be treated more vigorously, saving or greatly prolonging their lives.
Researchers now are looking at Hill and others who were treated during the 1960s and '70s to assess their quality of life and how to improve the long-term futures for those undergoing treatment now. Since a percentage have contracted second cancers, there's an increasing focus on what types of treatment can be given to kids so that it doesn't affect their quality of life down the road.
Much work remains, but the underlying message out of the progress being made is this: There's far more hope now than when the first line of Kim Hill's life story was being written. *
- Paul Vigna