From ‘Gene Sequencing’ To Successful Transplant: Nashawn Howard Is Now in His Treatment’s ‘Maintenance Phase’

Initially, nine-year-old Nashawn Howard complained of having heavy arms when swimming at his local recreation center. Not long after, he needed breaks whenever he walked to the bathroom from his room to take a shower,

Because of these occurrences, the boy's mom, Antoinette Howard, set an appointment with his primary care provider at Briarwood.

Following a quick assessment, the doctor sent Nashawn to the emergency department as she was reportedly not comfortable with how the child looked.

The boy was immediately taken back for a blood test showing his hemoglobin was lower than the normal. His blood test result had 2.4, instead of the normal level, which is 5.  Hemoglobin is a protein that helps in transporting oxygen in the blood.

What was even more alarming, according to reports, was that "his white blood cell count was 88,000" when the normal range was from 4,000 to 11,000.

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The Genetic Test Result

In 2018, the results specified Nashawn had cancer, and an acute lymphoblastic leukemia diagnosis was made. Following the analysis, treatments began, but the boy was said to be unresponsive to them.

To find out why, CS Mott Children's Hospital pediatric oncologist Rajen Mody, MD, MS conducted a "gene sequencing" of the child's tumor.

The doctor said, Nashawn appeared like any other leukemia patient, "But I quickly realized there might be something else at play" since the boy had a poor advanced reaction to the treatment.

As a result, the genetic test found that Dr. Mody said, "Nashawn had high-risk cancer gene features."

Specifically, the features found, the doctor explained, were an uncommon or unfamiliar genotype. Specifically, there were mutations discovered on two of the genes of Nashawn: the NRAS and FL3 genes.

According to the medical expert, the said unusual genotype, which affected how the boy responded to treatment, is a perfect example of why it is crucial to sequence minority children. Therefore, kids like Nashawn may not receive the necessary or life-saving medical treatment early.

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'Gene Sequencing'

According to Dr. Mody, the survival rate for minority children like Nawshawn is 15 percent fewer than their Caucasian equivalent.

While it may be difficult to determine the reason for such a difference in pediatric cancer, the medical expert explained that only about eight to 10 percent of the gene sequencing pool comprises "minority samples." The said the doctor added, should be near 30 or 40 percent.

These alarming percentages inspired Nashawn's doctor to develop a multi-institutional project, "Sequencing a multi-ethnic group of pediatric cancer patients like Nashawn from Ann Arbor, Detroit, and Flint."

Dr. Mody elaborated that every child deserves the best battling chance, and it may begin with gene sequencing.

The doctor said this approach was designed since a diagnosis of cancer on its own is quite overwhelming for a family, so they wouldn't want any other features to work contradicting them and the medical journey of their child.

A Successful Transplant

After his diagnosis, Nashawn began with his chemotherapy infusion treatment thrice each week. With this weekly session, the boy's doctor and family's hope was that overtime chemotherapies could be decreased to two times a week, once each week, every two weeks, and so on.

Fortunately, Nashawn responded favorably to treatments. And when it was almost the end of nine months from diagnosis, Antoinette and the care team met to discuss a bone marrow transplant.

The boy's mom shared, there was only a 17-percent chance that his brother would be a perfect match for the transplant. But "by the grace of God," she continued, "he was!" And the bone marrow transplant happened in April last year.

Even though Antoinette admitted, they were expecting "worst-case scenarios" after the procedure. However, Nashawn was doing great even during the post-transplant, she shared adding, instead of fluctuating as they expected them, her son's numbers, "Kept going up."

The boy was released from the hospital five days after his transplant. Now 11 years old, he is doing well in his treatment plant's "maintenance' stage.

With a grant of $592,100 from the Children's Hospital of Michigan Foundation for Dr. Mody's project and backing from Michigan Medicine and Chad Carr Pediatric Brain Tumor Center, other minority children may also have a result like the outcome of Nashawn more frequently.

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