When their son Eduardo’s leukemia returned last year, Javier and Guadalupe Canada were out of options. The couple didn’t have access to advanced pediatric cancer care where they lived in Calpulalpan, Mexico. They hoped to bring Eduardo to the United States for treatment, but they were unable to get visas.
Eduardo, however, was born in the United States and is a citizen. Desperate to save their 11-year-old son, Javier and Guadalupe decided to send Eduardo 2,300 miles away to Akron Children’s Hospital. A doctor friend with a travel visa accompanied him on the journey to Akron. Eduardo’s aunt lives here and would look after him.
Eduardo was so ill he couldn’t walk. He had been treated in Mexico for acute lymphoblastic leukemia (ALL), a cancer of the bone marrow. The family stopped treatment because they were unhappy with the medical care. They tried natural remedies. But Eduardo’s leukemia came roaring back.
Eduardo arrived at the Akron Children’s emergency room on a Friday night last August.
“Although it broke our hearts, we allowed him to come with a friend,” Guadalupe said through hospital Spanish interpreter Emily Lanier on a recent afternoon. “We felt secure in our hearts he was going to be okay.”
On that Friday night, Eduardo became the first case for Dr. Matthew Henderson, who had just started his fellowship at the Showers Family Center for Childhood Cancer and Blood Disorders.
“Eduardo showed up in our ER. They had a stack of papers from hospitals written in Spanish,” said Dr. Henderson. “We knew enough, that he had leukemia and obviously it had come back.”
Eduardo would need chemotherapy. If the treatment sent him into remission, he would then need a stem cell transplant. The procedure, sometimes referred to as a bone marrow transplant, involves wiping out the immune system and using stem cells to rebuild his bone marrow.
“He was so sick. The initial goal, beyond the transplant, was to get his family here so they could be with him in case these were his last days on earth,” Dr. Henderson said.
Dr. Henderson, oncology social worker Heather Lanfranchi and transplant coordinator Courtney Culbertson began an arduous task of contacting embassy and U.S. Customs officials to allow Eduardo’s parents entry into the United States, while trying to find a stem cell donor. Eduardo’s 12-year-old sister, Denisse, would be the most likely match.
“We had to type his sister,” Courtney said. “The best match for a donor is a full sibling. The problem was trying to type across the border.”
If Denisse were not a match, Eduardo’s chances of survival would drop dramatically. There was no compatible living donor in the national donor registry, which lacks a sufficient number of minority donors.
Akron Children’s sent the family kits to collect blood cells for typing, but couldn’t get the kits past U.S. Customs and Border Protection.
The National Marrow Donor Program came to the hospital’s aid and helped break the customs logjam. It turned out to everyone’s relief that Denisse was a perfect match.
Meanwhile, the family and the Akron Children’s team worked non-stop to get permission for Denisse’s entry into the United States.
After many hours of phone calls and letter writing, the Akron team caught a break when Heather reached the Mexican Consulate in Michigan. The Consulate helped them through a process called “humanitarian parole,” which would allow the family into the country for a limited time.
On Sept. 15, U.S. Customs told Heather the application was approved.
“I just stood up and said, ‘Oh my God,’” Heather said. “I called Guadalupe through a phone interpreter, and let her know. She was overjoyed.”
About 6 weeks after Eduardo showed up in Akron, his parents arrived with Denisse. By that time, Eduardo had responded well to chemotherapy. He had turned a corner.
“It was very emotional when they got here,” Heather said. “It was amazing to meet them after talking so many times over the phone, crying over the phone.”
The family has been staying at Ronald McDonald House Akron. Emily, the Spanish medical interpreter, has been at their side to bridge the language barrier.
“I was so happy when I saw my family,” Eduardo said through Emily, as he snuggled with his dad in a lounge at Ronald McDonald House. “First my dad came into my room with my sister and I hugged them. Then my mom came in and I said, ‘Finally!,’ because I was here with my aunt and it’s hard.”
Denisse missed her brother and was eager to come to Akron. The siblings are close and they look out for each other. Heather recalled that after they arrived, the family attended a monthly dinner hosted by the oncology and hematology department.
“It was something to watch them have a meal together for the first time in months, and the two of them, brother and sister, kicking each other under the table.”
Eduardo underwent the stem cell transplant in December. He received high doses of chemotherapy and radiation that depleted his immune system, killed off any residual leukemia and made room for the new bone marrow.
Denisse underwent general anesthesia as doctors extracted the stem cell-rich bone marrow from the back of her hips. The next day, her stem cells were infused into Eduardo. Denisse’s stem cells, which develop into different types of blood cells, would restore his damaged bone marrow.
Eduardo spent 43 days in isolation in the hospital. He is feisty and would question his mother about why he needed the treatment. Guadalupe explained that chemotherapy was like fumigating a house for cockroaches, and that the transplant was like getting new living room furniture.
Guadalupe read as much as she could about the disease.
“She knows all about my medication. She has it recorded right here,” Eduardo said, playfully pointing to his forehead.
Guadalupe said the family is grateful for the people at Akron Children’s and Ronald McDonald House.
“We didn’t just find help for Eduardo, we found a really beautiful family,” she said. “This house is a refuge. It’s a place where we find calm and peace.”
She spoke about Eduardo’s original prognosis and how difficult it was during the month and a half he was away from her.
“There is a time to cry and I cried a lot. I felt at times I was in a desert and didn’t know which way to go. Then I’d say Eduardo needs me. No more time to cry.”
Eduardo is in remission, but he must stay close to the hospital for a while. He is seen weekly and monitored for signs of transplant rejection. His parents’ visas were just extended for 6 months so they can remain in the United States with him.
“In January he’ll be one year out from transplant and able to be safely transferred to a hospital closer to home in Mexico,” reported Lanfranchi.