After two relapses of leukemia, Marky was offered a new treatment

In May 2017, when Heidi Czutrin boarded her flight from Hong Kong to Toronto, she expected to return home to her two children — not directly to The Hospital for Sick Children (SickKids). Her three-year-old son, Marky, had been fighting what she thought was a nagging ear infection. But at a follow-up appointment, Marky’s paediatrician noticed his spleen and liver were enlarged. He was sent to SickKids immediately for blood work. When Heidi made it to the emergency department that night from the airport, it would be the first of three times she would hear doctors say, “Your son has cancer.”

Marky was diagnosed with acute lymphoblastic leukemia (ALL). Additional genetic testing revealed his leukemia cells harboured two genetic variations, each known to cause the disease and make it very hard to treat.

He spent the first five days in the critical care unit, where doctors worked to stabilize him. He was then admitted to the oncology inpatient unit to begin a 12-month aggressive treatment program. “We spent 90 per cent of our time at SickKids that year,” says Heidi. “We met so many wonderful staff — strangers who cared for us like we were their own family. I never knew people like that existed because I never needed them.”

After a gruelling year, Marky was sent home on a maintenance treatment program. Only three months later, results from a routine check-up showed Marky had relapsed. “It was such a huge shock because Marky was getting better — his energy was back, and his hair was growing in. He seemed like the picture of perfect health,” remembers Heidi.

In September 2018, Marky’s team prepared him for a bone marrow transplant (BMT) to try and save his life. SickKids has one of the world's most comprehensive paediatric BMT programs and performs more than half of all paediatric BMTs in Canada. Marky was in good hands.

But the transplant took a toll. The next six months were beset with rare complications and harsh side effects. Marky had barely recovered before he relapsed again — on his fifth birthday.

Thankfully, Marky qualified for the newest form of treatment for blood cancers, called CAR-T cell therapy. He would be the 14th patient in Canada to receive this therapy, which was his only chance for survival.

CAR T-cell therapy is part of a new wave of treatments called immunotherapy, which harnesses the body’s own immune system to fight diseases. The treatment involves removing patient T-cells — white blood cells that usually fight viruses — and engineering them to find and kill leukemia cells. These supercharged T-cells are then infused back into the patient’s bloodstream where they can get to work fighting cancer cells.

According to Dr. Jim Whitlock, director of the Garron Family Cancer Centre at SickKids, the therapy is revolutionary. “It’s incredible to see. Over 50 per cent of patients with the most common type of previously incurable leukemia have had a sustained response to CAR T-cell therapy,” he says. “We are working to bring that number up.”

On June 10, 2019, Marky received his cancer-fighting CAR T-cells. Heidi says, “I remember about 20 people crowded around during the infusion, and doctors had 30 minutes to get the cells into his body. You could feel the energy in the room.” Only 29 days later, Marky was in remission.

Today, Marky is cancer free. He now visits the hospital every three months to address the long-term side effects of his cancer treatments and for follow-up care. Mostly, he doesn’t remember his experiences as a young patient at SickKids — but his family will never forget them.

Torstar, the Star’s parent company, is in a fundraising and educational partnership with The Hospital for Sick Children to help raise $1.5 billion for new facilities. This content was produced by SickKids as part of that partnership.