Natalie’s story: From diagnosis to double transplant

physician, who ordered a repeat CBC. When the white blood count remained elevated, I was referred to Dr. H. Kent Holland at The Blood & Marrow Transplant Group of Georgia. Within a few weeks of those tests and a bone marrow biopsy, I was diagnosed with acute lymphoblastic leukemia (ALL).

What treatment did you receive?

Within hours of my diagnosis, I was admitted to Northside Hospital’s Bone Marrow Transplant (BMT) Unit for three weeks to begin treatment. The first step was several phases of Hyper-CVAD, a high-dose chemotherapy regimen specifically designed to fight aggressive blood cancers like ALL. Over four months, this intensive treatment worked to eliminate the leukemia cells in my body. Because the treatment is so aggressive, it required either hospitalization or daily monitoring in the BMT clinic, which meant I could not work. I also had to avoid all public spaces due to my severely weakened immune system.

Once I completed Hyper-CVAD, I underwent a stem cell transplant using my brother as the donor. Because we were a 100% match, we had high hopes for success. Before the transplant, I went through a process called conditioning — preparation for receiving donor stem cells. This involved a week of high-dose chemotherapy combined with twice-daily full-body radiation to clear out my bone marrow and make space for the new, healthy cells.

Unfortunately, within the first 100 days following the transplant, I developed a secondary cancer: acute myeloid leukemia (AML). This is a rare but serious complication, and my doctors quickly pivoted to a new treatment plan. I began another intensive chemotherapy regimen, which combined multiple chemotherapy drugs and pegaspargase to target AML. After three months, I underwent a second stem cell transplant.

This time, the transplant was a haploidentical transplant, or haplo transplant, using my mother as the donor. A haplo transplant uses a donor who is only a 50% genetic match, which is possible thanks to advances in transplant techniques that reduce the risk of complications.

The post-transplant recovery is a grueling, phased process with daily BMT clinic treatments, including blood and platelet transfusions, fluids and constant monitoring for complications. The main complication is host-versus-graft disease (HVGD), which happens when your donor’s cells fight with your own, as well as infection. Both can lead to life-threatening illnesses. I had a mild case of HVGD that attacked my skin, resulting in an itchy rash on my torso. I was also hospitalized several times after my port became infected, with one episode leading to a stay in the ICU when my body went into septic shock.

I began to feel like myself after my mom’s cells took over and I began to rebuild my immune system. I felt less weak, my mobility improved and my appetite began to return. I started to choose nicer outfits instead of sweats and overworn T-shirts for clinic visits and even began wearing a bit of makeup. That small shift helped me emerge from the foggy identity of being a patient. About eight months after my second transplant, I returned to work and began to resume old routines like going to church.