A 6-year-old Belleville girl was just weeks from completing chemotherapy treatments for her crushing childhood cancer when she was diagnosed with another cancer in October: leukemia.
Her family and friends have been praying for a bone marrow donor match. Her doctor’s “No. 1 choice” would be a match with Maranda’s younger sister, Mariah, or older brother, Randy.
“Any single sibling has a one in four chance of matching,” said Dr. William Ferguson, Maranda’s oncologist. He spoke to the News-Democrat about her treatment with permission from the Wilborn family.
“Those close relations tend to be the best outcomes,” he said.
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Mariah is the one. She turned 4 on Thursday.
Getting a new diagnosis
Her parents had just started letting Maranda Wilborn go outside again, and she had started first grade after missing nearly every day of kindergarten at Jefferson Elementary School.
“Her teacher was telling us Maranda was just starting to open up,” said the girl’s dad, Randy Wilborn.
Then Maranda fell ill with a fever in late October, which meant another trip to Cardinal Glennon’s Emergency Department. A routine blood test revealed the new battle for the family.
“What hurt so bad was, we had four weeks,” left of the chemotherapy for the first cancer, said her mother, Myiesha. “To tell her we had to push the chemo back was so hard.”
Acute myeloid leukemia, a cancer that starts in the bone marrow, often acts more aggressively than other leukemia, especially when it follows another cancer, her doctor said. It’s also more likely to come back.
“We know that these are sneakier than your average AML,” Ferguson said.
That said, there was plenty on Maranda’s side even before finding her sister was a match.
“This is not a Hail Mary pass,” Ferguson said. “We’ve got a very reasonable chance of treating it successfully.”
Throughout the discoveries of Maranda’s cancers and treatments, the Wilborn family has relied on their faith. That faith is perhaps even stronger now, Myiesha and Randy said.
“We saw what the Lord has done. We’re not worried,” Myiesha said.
The oncologist has reassured the family that treatment can be successful. That first step was finding a donor.
“She’s a fighter. She’s got a great attitude, a great family,” Ferguson said. “We are doing everything we can to be invited to her college graduation.”
The family is accepting donations to help with costs associated with transportation and missed work to accommodate Maranda Wilborn’s treatments. Go to www.gofundme.com/family-of-maranda-wilborn for more information.
Maranda’s oncologist says he didn’t actually believe the blood count test showing AML when he saw it.
“She looked great. I actually didn’t believe the (differential blood count test) when they forwarded it. I went down, looked at the slide, I looked at her. She had no fever, no pain; she actually looked quite good,” Ferguson said.
What happens next
Maranda was to go to the hospital for a planned five-day course of chemotherapy on Thursday, her mother said. Thursday is also Mariah’s fourth birthday, and the girls planned to have cake and watch movies at the hospital. During Maranda’s last stay, they watched “Home Alone” and all its sequels.
Myiesha thinks the family will be home for Thanksgiving, unlike last year when the family stayed at the hospital for every birthday, anniversary and holiday. She’s looking forward to feeding her daughter, knowing that Maranda is usually sad to be in the hospital and doesn’t eat well there.
“At home it’s ‘give me give me give me,’” Myiesha said, laughing.
Now that a match is made, doctors will soon use high doses of chemotherapy to “give leukemia a last kick and get her bone marrow out” to make room for the healthy donor bone marrow, Ferguson said.
The chemotherapy she’s undergoing before Thanksgiving was the course being continued to keep the leukemia cells low until the transplant process could start, Ferguson said. The hope is that the immune system brought in from the donor bone marrow will “get those last few.”
“Realize those ‘few’ may mean millions (of leukemia cells),” Ferguson said. “When you have enough to see in the bloodstream, you have billions.”
He said some people with AML are in remission but keep undergoing chemotherapy for that reason. This form of leukemia is “more aggressive” in coming back, he said.
The higher dose chemotherapy and early donation process will leave Maranda’s immune system completely unable to fend off the slightest illness. She will have to stay in an isolated hospital environment for several weeks, and be “pretty limited” socially for about six months.
As a donor, Mariah should recover quickly. Ferguson said the younger sister will have “a lot of needle sticks and discomfort that gets better after a few days.”
“It’s boring,” he said. “They’re stuck in bed for four hours. It’s easier in the iPad era than before.”
Donor’s bone marrow regenerates within a couple of days, he said. Recipients take longer, which leaves them open to infection longer.
“We really don’t trust the immune system to fight off these things,” Ferguson said, explaining that the new cells would need six to 12 months to regenerate an immune system, and Maranda will need to undergo all baby and child vaccinations again.
“Kids go through this whole process better than adults. She looks good right now, at least right now we’re not dealing with lots of infections of other problems,” Ferguson said. “She’s got a great attitude. She’s got a great family.”
Typically, bone marrow donors have to be 18 to donate; the bone marrow registry website says the upper age limit is generally 44. Ferguson explained that “extra safeguards are in place” to ensure exceptions such as under-18 siblings are donating in a safe and ethical manner.
“In my experience, most siblings are pretty eager to help the brother or sister,” Ferguson said, even those who “fight like cats and dogs because that’s what brothers and sisters do.”
She’s a fighter. She’s got a great attitude, a great family. We are doing everything we can to be invited to her college graduation.
Dr. William Ferguson, Maranda Wilborn’s oncologist
Maranda and her family have a reputation around Cardinal Glennon and The Costas Center, where she receives treatment. She’s quiet and reserved, and they love and support one another.
Through the months of sickening chemotherapy and painful platelet infusions, the doctor and nurses at Cardinal Glennon see their patient of more than a year as a determined fighter but also a quiet girl starting “to come out of her shell a little,” Ferguson said.
“She’s just a sweet girl; you can tell just by looking. The whole family is. They come in together all the time,” said nurse Elena Antoine, who works at The Costas Center.
The family generally spends most of the day at The Costas Center for Maranda, Antoine said.
“The kids all play together when they are here; they make the most of it,” Antoine said.
Maranda last week said, in the quiet voice she typically saves for non-family, that Antoine was her favorite nurse.
Antoine laughed, recalling the time she saw a video of Maranda “being Maranda at home, talking, singing, just being her goofy self.”
“You don’t have me fooled, I told her. I know who you are,” Antoine said she told Maranda.
It’s not all games and laughter at The Costas Center, Antoine said. Maranda has had an allergic reaction to the platelets she gets as part of her chemotherapy treatment, and the girl was itching, coughing and vomiting.
“And that little girl is just sitting there with her legs crossed, tears coursing down her face just ... keeping her same composure,” Antoine said.
Bone Marrow registry
There are some 40 million people on the bone marrow registry, oncologist Dr. William Ferguson said. “But then look at the ones you can actually find — people move, grow older and die — estimate is about 20 million.”
“If you’re Caucasian you’ve got a pretty good chance of getting a match (from the national registry). If you’re a minority, the chance is smaller.”
For more information on the National Bone Marrow Registry, go to www.BeTheMatch.org.