n Tumor discovered after 5-year-old suffered ulcer as a result of experimental medication
Five-year-old Angela Rushford of Rockford has been diagnosed with post-transplant lymphoproliferative disorder (PTLD), a rare form of cancer, six months after undergoing a kidney transplant to correct polycystic renal failure.
Doctors had hoped to send Angela home last weekend, but her condition deteriorated, and she has been moved to intensive care. Results of a PET scan showed that the cancer had spread to five different places in her small intestine. Angela continues to lose weight and has been passing a lot of blood, a side-effect of an ulcer she suffered as a result of her experimental immunosuppressive medication. She received a blood transfusion Monday evening.
Shes not really doing too good, said Tony Rushford, Angelas father. Shes just losing weight like crazy. [Doctors dont think the cancer has spread], but they keep getting more and more nervous.
Doctors at the University of Wisconsin Hospital in Madison believe the cancer is a result of a combination of mononucleosis (mono), which was carried through the transplanted kidney, and experimental immunosuppressive medication. All kidneys carry mononucleosis, but transplant recipients suffer from an impaired immune system that often allows for an uncontrolled increase of mono cells, which results in PTLD. PTLD occurs in about 1 percent of kidney recipients. About 50 percent of PTLD patients experience rejection, and 50 percent of those experiencing rejection lose their transplanted organ.
One percent of transplant recipients get this disease, said Patty Rushford, Angelas mother. She was one of the unlucky ones. But its very curable. Most people get through it. She could lose her kidney, but they said usually they dont.
Angelas story gained national attention last winter after Patty Rushford placed a free classified ad in The Rock River Times seeking a kidney donor. Angela had been on a list for a kidney for about six months to no avail. An unemployed welder, 38-year-old David Harper of nearby Mount Morris, ran across the ad while reading the newspaper and eventually became the donor.
Harper, who remains close to the Rushfords and whom Angela refers to as Uncle David, said he felt terrible about Angelas cancer. Its my kidney that gave it to her, he said.
Julie Steller-Tilbury, regional development specialist for the Gift of Hope Organ and Tissue Donor Network, said cancer is common in many transplant cases, especially pediatric cases. Its something thats not uncommon to seecomplications in pediatric transplants, she said. The pediatric patient is just much more difficult to regulate than the adult.
Patty Rushford said doctors expect Angela to make a full recovery, and said the cancer could be cleared within a month. Yet, depending on the severity of the disorder, Angela could either lose her kidney or the condition could become life threatening.
Shes real thin and weak right now, Patty Rushford said. It sounds bad, just the word. Were lucky we caught it when we did. Shes tough, and I know shell get through this.
Doctors hope to eradicate the cancer by taking Angela off her immunosuppressive medication and putting her on Ritoxin, a strong antibody cancer treatment. However, Angela may have to undergo radiation and chemotherapy.
Angela had been complaining of extreme stomach pain for about a month. Her parents thought it was just a case of stomach flu, but her condition worsened, and they eventually took her to University of Wisconsin Hospital. Doctors at the hospital discovered Angela had developed an ulcer from her medication, which they said was common of many transplant recipients. Doctors found a cancerous tumor while looking for the ulcer.
Her stomach was killing her, Patty Rushford said. Thank God she had the ulcer thats what made them look. They found it, and thank God they found it.
Patty Rushford said she doesnt want Angela to take the experimental immunosuppressive medication again.
She had this for a long time and was suffering at home with only Tylenol, Patty Rushford said. And thats if she would take it. Shes real feisty. She was saying shed rather die instead. And I was just so depressed and felt so bad for her and had all these emotions. Thank God we caught it when we did. Im very strong about this, and I dont want her to see me worry because shes not stupid, and she picks up on that.