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Learn More: About Caden | About Neuroblastoma | About Cord Blood Transplant Facts | About Childhood Cancer Facts and Warning Signs 

Caden Seth Ledbetter

Who is Caden Seth Ledbetter?

• Born to Lexie and John Ledbetter on Aug. 2, 2005.
• Caden means “warrior” and/or “friend.”
• Seth means “appointed by God.”
• Caden’s parents stored his umbilical cord blood with a private cord bank, although his older brothers’ cord blood was not stored.
• He has twin five-year-old brothers, Zachary and Joshua.

Caden’s Diagnosis and Treatment

• On July 5, 2007, Caden’s mother discovered a lump on his head.
• Caden was diagnosed with stage IV neuroblastoma on July 28, 2007.
• Tumors were found in his left adrenal gland, liver, lower back, and two locations on his head; cancer was also found in Caden’s bone marrow. His left adrenal gland was surgically removed.
• Caden started chemotherapy on Aug. 2, 2007, his second birthday.
• He has had two surgeries, six chemotherapy treatments, and one biopsy.
• After the third chemotherapy treatment, scans revealed he was cancer free except for the two lumps on his head.
• He has had repeated hospitalizations, including each chemotherapy treatment, since his diagnosis, but was able to spend Thanksgiving at home.

Caden’s Transplant

• Caden was admitted to the hospital on Dec. 19, 2007, to begin the cord blood transplant process.
• Six days of intense high-dose chemotherapy treatment preceded the transplant to kill any remaining cancer cells and severely suppress his immune system.
• On Dec. 28, 2007, Caden received a cord blood transplant intravenously.
• Caden’s transplant is extremely rare because it used blood from his own umbilical cord to fight neuroblastoma.
• He was in a special isolation unit at the hospital during the transplant process.
• Caden’s hospital stay for the transplant is expected to be three to four weeks to allow the stem cells to start replenishing the cells destroyed by the chemotherapy, barring any complications.

Helping Caden

A fund has been established to assist with Caden’s medical expenses. Contributions can be made through the following site: Caden’s Journey 

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About Neuroblastoma

Neuroblastoma is one of the 12 major childhood cancers, and is difficult to treat. Neuroblastoma is a tumor in which cancer cells form in nerve tissue of the adrenal gland, neck, chest, spinal cord, and other areas of the body.

• Approximately 500 to 1,000 children are diagnosed with neuroblastoma in the United States each year.
• Doctors have known about neuroblastoma for approximately 35 years.
• Neuroblastoma is primarily diagnosed in children ages 14 and under, with most cases in children younger than 5 years.
• The cause of neuroblastoma is unknown, and it is more likely to occur in males than females.
• Neuroblastoma is difficult to diagnose in small children, and its progression is often rapid and painful.
• Neuroblastoma accounts for 8 percent of childhood cancer cases, but is responsible for 15 percent of all childhood cancer deaths.

Diagnosis and Prognosis of Neuroblastoma

The age of the child at diagnosis and the phase of the disease are the two most important factors in evaluating the prognosis for a child with neuroblastoma.

• Like many cancers, early diagnosis is an important element for survival.
• Neuroblastoma is often discovered when a mass or tumor is felt on a child’s body, often the abdomen.
• Symptoms of neuroblastoma vary from no outward symptoms to those common with childhood illnesses such as bruising, mild flu symptoms, diarrhea, and loss of appetite.
• Other acute symptoms include bone pain, hypertension, anemia, skin nodules, a pronounced lump, or a refusal to walk.
• Neuroblastoma can be diagnosed through a urine test, ultrasound, CT scans, or MRI scans, and biopsy of tissue.
• Infants less than one year old have a better chance for remission and survival than older children.

Neuroblastoma Classification

There are three risk groups for determining the proper treatment for neuroblastoma. The proper risk group is determined by stage of the cancer, age of the child, tumor biology, size and position of the tumor, and whether the tumor has spread.

• Low Risk: Patients classified as low risk have three specific characteristics. The tumors are localized to one area, can be mostly or completely removed by a surgeon, or have features which indicate the tumor is unlikely to spread or reoccur.
• Intermediate Risk: Patients classified as intermediate risk have tumors that are difficult to remove completely with surgery. Their tumors also have some mixed cell characteristics and the patient may have symptoms stemming from the tumor compressing other organs.
• High Risk: Patients with high risk neuroblastoma have tumors that show aggressive characteristics. In addition, the disease is found in multiple places throughout the body. The prognosis for patients with high risk neuroblastoma is significantly worse than low and intermediate risk.

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Cord Blood Transplant Facts

Medical researchers are making great strides in treating serious diseases, affording physicians with new techniques, procedures, and technologies. Cord blood transplants are one example which is showing great promise for treating serious and often fatal diseases such as leukemia, sickle cell anemia, lymphoma, immune system disorders, and neuroblastoma. Cord blood, the blood that remains in the umbilical cord after a baby is born, is rich in stem cells, which have proven to be an effective alternative in treating diseases that would otherwise require a bone marrow transplant. There are three types of transplants:

• Autologous transplants: patients receive their own stem cells.
• Syngeneic transplants: patients receive stem cells from their identical twin.
• Allogeneic transplants: patients receive stem cells from their brother, sister, or parent. An unrelated donor also may be used.

Since the first cord blood transplant in 1988, thousands of cord blood stem cell transplants have been successfully performed, but transplants attempted with a patient’s own umbilical cord blood remain extremely rare. Only three documented transplants have used the child’s own cord blood to treat neuroblastoma. Estimated odds of a child needing a cord blood stem cell transplant vary greatly, anywhere from one in 1,000 to one in 200,000.

Most cord blood transplants in the United States are performed on children because the amount of cord blood may not contain enough cells to treat adults, but research is expanding the possibility for adults, too. Current research in the field of transplant and stem cell therapy includes a focus on Parkinson's disease, stroke, diabetes, Lou Gehrig’s disease (ALS), spinal cord injuries, and cardiac repair.

After cancer ridden stem cells are destroyed by high doses of chemotherapy and/or radiation therapy, a cord blood stem cell transplant restores healthy stem cells to take the place of the cancer cells and build up the immune system. Cord blood stem cells, like bone marrow, develop into red blood cells, white blood cells, and platelets. Research also has shown cord blood cells can develop into brain, heart, and liver cells. The cord blood stem cells are able to replace other cells in the body that are abnormal, weakened, or destroyed by disease.

The Transplant Procedure and Post-Transplant Activity

Pre-Transplant Activity. Prior to a cord blood transplant, patients may have surgery to remove tumors and undergo multiple rounds of chemotherapy and/or radiation. Physicians hope the chemotherapy and radiation will rid the patient’s body of disease and allow the healthy, transplanted cord blood cells to take over.

Cord blood is obtained from a cord blood bank. Cord blood is originally collected from the umbilical cord at birth, approximately three to four ounces of blood is drawn from the umbilical cord and placenta, posing no risk to the child or mother. It is then kept frozen in a highly controlled environment at a public or private cord blood bank until needed. Public banks are searchable by physicians to find a match for their patients. Private banks reserve the cord blood only for the child and members of his/her family.

Transplant. The transplant process begins with the patient receiving a high dose of chemotherapy and/or radiation to eradicate any cancer that is left in the patient’s body, and to ablate the patient’s immune system as well. Then, the patient receives the transplanted stem cells intravenously, similar to a blood transfusion. The intravenous part of the transplant takes approximately 15 minutes.

Post-Transplant Activity. Once the stems cells have been transplanted into the patient, they enter the bloodstream traveling to the patient’s bone marrow. Through a process called “engraftment,” the stem cells start to produce new white blood cells, red blood cells, and platelets. The patient is typically kept in isolation for at least two to four weeks while the engraftment process occurs, though it can take months and even years for patients’ bodies to restore full immune function. Through blood tests, doctors are able to evaluate and confirm that the cancer has not returned and new blood cells are forming. All cord blood transplant patients have lowered immune systems after their procedures. Texas Oncology cord blood transplant patients stay in a state-of-the-art 13-bed hospital unit designed to keep infections out. In addition to specialized nursing, the unit has a water purifying system and air system with high-efficiency air filters designed to keep bacteria out and keep clean air in the unit.

Side Effects. Unfortunately, there are many side effects that could occur during the cord blood transplant process. Among them is an increased probability of infection and bleeding from the high dose of chemotherapy and radiation given prior to the transplant. Doctors give antibiotics to prevent or treat this possibility. Patients may also receive transfusions of platelets to prevent bleeding and red blood cells to treat anemia. Other short-term side effects include nausea, vomiting, fatigue, loss of appetite, mouth sores, hair loss, and skin reactions.
Long-term side effects caused by the high doses of chemotherapy and/or radiation therapy given prior to the transplant may include infertility, cataracts, new cancers, and damage to the liver, kidneys, lungs, and/or heart.

Sources: National Cancer Institute, National Cord Blood Program, and Journal of Pediatric Hematology/Oncology

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Childhood Cancer Facts and Warning Signs

More kids die from childhood cancers than any other disease. In fact, cancer kills more children than asthma, cystic fibrosis, diabetes, and pediatric AIDS combined. By the age of 20, one in every 330 Americans will develop cancer. Approximately 10,400 children and teens ages 0-14 years will be diagnosed with cancer this year in the United States.

Treating childhood cancer differs greatly from treating adults with cancer. Children diagnosed with cancer benefit from being treated at centers specializing in pediatric oncology. These centers use protocols developed specifically for children, specialized pediatric equipment, and often have access to clinical research studies, the latest technology, and new therapies designed particularly for fighting childhood cancer.

Characteristics and Causes

• Childhood cancers fall into 12 major categories, with leukemia having the highest incidence rate.
• Childhood cancers rarely are found in adults. They are almost always exclusive to children.
• Cancers diagnosed in children react differently than most adult cancers.
• Cancer in children is random. No ethnic group, socioeconomic class, or geographic region has more cases than any other.
• Cancer in children tends to form in parts of their bodies that grow and change, such as their blood system, brain, and kidneys.
• The origin of most childhood cancers is unknown and cannot be prevented at this time. Adult cancers often result from smoking, diet, occupation, or exposure to agents that cause cancer.

Treatments and Death Rates

• The childhood cancer mortality rate has declined 48 percent since 1975.
• Approximately 2,300 children will die this year from cancer.
• Cure rates vary for specific cancers depending on the stage of diagnosis and the cancer type; some forms of cancer remain resistant to treatment. For example, due to better treatments and research, children with leukemia can be cured almost 80 percent of the time. Neuroblastoma is among the most difficult childhood cancers to cure.
• The five-year survival rates for childhood cancer have increased greatly over the past 30 years. Prior to 1970, children diagnosed with cancer would survive less than 50 percent of the time. Today, due to modern forms of treatment, the five-year survival rate is almost 80 percent.

American Cancer Society’s Childhood Cancer Warning Signs

Continued, unexplained weight loss

Headaches with vomiting in the morning

Increased swelling or persistent pain in bones or joints

Lump or mass in abdomen, neck, or elsewhere

Development of a whitish appearance in the pupil of the eye

Recurrent fevers not due to infections

Excessive bruising or bleeding

Noticeable paleness or prolonged tiredness

Sources: American Cancer Society and National Cancer Institute