Steve Dung stands by as daughter Alana sits in a crib specially
designed for radiation therapy. She passes time in the crib watching
Barney videotapes. Photos by Matt Hagen, special to the Star-Bulletin

The opponent here is cancer, and it's a winner-take-all proposition.

Two-year-old Alana Dung, diagnosed with acute myeloid M-7 leukemia, has made it to the finals.

Barring any delays, today she will become the 60th person from Hawaii to receive a bone-marrow transplant at the Hutchinson Center. The bone marrow was harvested from an unrelated donor in Taiwan and was brought here this afternoon by Dr. Jean Sanders, head of pediatrics oncology, who picked it up on the way home from a business trip.

A successful transplant is Alana's only hope of beating the leukemia that threatens her life.

Alana, dad and Barney share a moment.

To even have a chance at winning, considering the odds of finding an unrelated donor - let alone doing it in two months - defines the no-quit spirit of family and friends on this stirring odyssey, which began in mid-April with public plea for help.

"There's only one word to describe it," said Dr. John Hansen, one of the pioneers of unrelated bone-marrow transplants and head of the Immunogenetics Program at the Hutchinson Center. "It's a miracle."

The bone marrow will be given to Alana intravenously through aHickman catheter implanted in her chest. The procedure is similar to a blood transfusion and should take two to four hours.

"From her point, it will be rather uneventful," Hansen said. "It should take about 21 days before it kicks in. This waiting period is critical."

Alana yesterday received the last of her three-a-day pretransplant radiation treatments designed to wipe out her own bone marrow. The process renders her immune system defenseless until the new graft begins to grow.

It's a high-risk period as bacterial, viral and fungal infections, bleeding and organ failure can be life threatening.

"They start feeling listless after two or three days so we try to be more comforting with them," said Ping Guanco, a nurse at Hutchinson Center since it opened in 1975. "But as their counts come back, they become more playful and we start encouraging them to eat even though there might be some pain in their throats."

Kool-Aid, Popsicles and oatmeal are usually on the start-back menu.

During the waiting period, nurses keep a close eye on young patients as well as their parents.

"An adult patient can express what he feels but a child can't, so we need to be very alert," Guanco said.

Barring complications, Alana could be discharged to outpatient care in 30 to 40 days. She will most likely be required to remain in Seattle for 90 to 100 days during the post-transplant period.

It usually takes up to nine months for the immune system to become fully normal.

"My happiest time is when they come back for their one-year checkup," Guanco said. "Most of them will come and say hello.

"At Hutch Center, smiles are also medicine, which is why we don't wear uniforms or make it seem like a hospital," she added. "The kids here have a grim illness and the last thing they need to see are grim faces. By encouraging them to be kids, we get very attached to them."

It's difficult to predict Alana's chances for a full recovery, Hansen said.

"With unrelated donors, there are other genetic factors we can't account for," Hansen said.

"There can be conflicts. We can't control the risks.

"But the goal is to cure Alana of leukemia," he added, "and if she can make it past five years, the chances are high the leukemia won't occur again."

If the first transplant is unsuccessful, a second one is very unlikely. "You can't hurry up and perform a second transplant," Hansen said.

Alana was in good spirits yesterday morning. She reported to her morning radiation treatment without a whimper, requesting the same "Barney the Dinosaur" videotape she has watched throughout the sessions.

Alana also helped her mother, Adelia, celebrate a birthday.

"She blew out the candles and got into the chocolate cake," said Alvin Chung, Alana's uncle. "We checked with staff and they said her count was high enough for her to have some cake."

The family also had a noodle dish. "It's for long life for all of us," added Chung, who was wearing a "Refuse to Lose" shirt.

Alana sits on dad's lap awaiting her last radiation treatment yesterday.
Photos by Matt Hagen, special to the Star-Bulletin