Medical Miracles

Astonishing stories of patients who cheated death or permanent disability, and the physicians who saved their lives.



(page 4 of 8)

Dr. Regina Jakacki can’t stifle a smile when she talks about Leah Koller. Her smile often becomes an out-and-out grin. That’s because of how Leah’s doing. At 12, eight years after she was diagnosed with a glioma — a complicated form of brain tumor — the Waynesburg girl is thriving, thanks to an experimental treatment spearheaded by the Brain Care Institute at Children’s Hospital of Pittsburgh of UPMC.

The team included Dr. Jakacki, director of the neuro-oncology program, and her colleague, pediatric neurosurgery chief Dr. Ian Pollack. The treatment that has been working for Leah is, in essence, a vaccine — not entirely unlike a vaccination against mumps or measles — that attacks certain proteins in the tumor. A team at the University of Pittsburgh and Children’s developed the vaccine, which is the first of its kind in the country.

Because of the tumor’s location, doctors knew that removing it would cause her to be paralyzed on her right side. And it also appeared that Leah’s tumor was spreading throughout the brain, which made surgery an even less viable option. Radiation therapy to the brain can cause severe developmental damage in young patients. So last year, with the Kollers’ blessing, they turned to the experimental vaccine.

The idea of using vaccines came out of a longstanding program that examined how they’d affect malignant brain tumors that weren’t responding to standard therapies like surgery, radiation and chemo, which aren’t curative. Doctors at Children’s suspected that immunotherapy might work better. So they looked at the antigens on the tumor cells and identified several targets — what Dr. Pollack calls “little snippets of protein” that could be used as a vaccine. An early study in adults was encouraging, so Drs. Pollack and Jakacki moved on to children, who tend to have more robust immune systems.

At first, in 2009, even the doctors were skeptical about the vaccine. “I wasn’t a complete believer,” Dr. Jakacki recalls. “I wasn’t even sure people were going to come for it.” For starters, a patient needed to have a certain tissue type to be eligible — a type that is found in only about 40 to 45 percent of the general population. “Initially, it sounded like a pie-in-the-sky kind of thing,” Dr. Jakacki says.

Not much happened at first, and few volunteers came forward. Then enrollment peaked, and progress surfaced in a few patients. One child got much worse during the treatment, and the tumor looked much bigger. However, throughout the next several weeks, the child improved, and an MRI showed that the tumor had shrunk to less than half the size it had been, indicating that the tumor had swelled as the vaccine attacked the tumor cells — but the vaccine was indeed working. Says Dr. Jakacki, “We kind of looked at each other and said, ‘Really?!’”

Leah’s tumor was low-grade and slow-growing yet complicated; it started expanding into the coating of the brain. Leah was put on chemo, but the radiation that could have really tackled the tumor would have also affected her cognition. When she started the vaccine, she had few side effects. But an MRI taken after nine weeks showed the tumor actually seemed worse. They kept going. Then it looked stable. Then, slowly, it shrank — enough that its shrinkage finally became obvious.

Now, Leah’s tumor is about 50 percent smaller — 75 percent, Dr. Jakacki says, if you take into account dramatic shrinkage in the areas of metastasis. Twenty-seven children have tried the treatment, and a dozen remain on it. And Drs. Pollack and Jakacki are looking at ways the vaccine usage might be expanded. That, too, makes Dr. Jakacki grin.

Meanwhile, Leah is starting to flourish.And there’s a new member of the Koller clan these days, not related by blood but rather sweat and tears: Dr. Jakacki, who finds herself an honorary Koller for life.

“She’s just part of our family, whether she wants to be or not,” says Leah’s mother, Raelene. “She’s part of us now.”
— Ted Anthony

Edit Module

Edit ModuleShow Tags

Hot Reads

Bucket List: 25 Don't-Miss Experiences for the Yinzer in All of Us

Bucket List: 25 Don't-Miss Experiences for the Yinzer in All of Us

You'll have to work hard to make it through the 'Burgh Bucket List — but every entry is more than worth the effort.
Finally Home: How Pittsburgh Won Over Troy Polamalu

Finally Home: How Pittsburgh Won Over Troy Polamalu

Troy Polamalu came to Pittsburgh craving the California sun. Nearly a dozen years later, he shares a rare glimpse of the relationships he developed here — with his God, the Steelers Nation and the city he and his family now call home. One thing is certain: he never wants to leave.
Granting the Perfect Wish

Granting the Perfect Wish

By fulfilling the wish of a 12-year-old boy, PittGirl learns that you don't always need a lot of money to grant the perfect wish.
Men's Winter Fashion: Season for Swagger

Men's Winter Fashion: Season for Swagger

Try an updated take on traditional trends with these winter must-haves for men.
Edit ModuleShow Tags

The 412

America’s Smartest Cities: Pittsburgh is No. 2

America’s Smartest Cities: Pittsburgh is No. 2

Has it seemed a bit smarter around here lately? Well, consider this . . .
15 Beautiful Photos of Pittsburgh’s 2014 Light-Up Night

15 Beautiful Photos of Pittsburgh’s 2014 Light-Up Night

Our city never looks brighter than on this annual, celebratory nod to the beginning of the holiday season.
Two Cameras to Keep an Eye on Pittsburgh’s Bald Eagles

Two Cameras to Keep an Eye on Pittsburgh’s Bald Eagles

A Murrysville security company plans to install the new cameras, which should provide high-definition of the Hays eagles.
Pittsburgh Offers Free Holiday Parking

Pittsburgh Offers Free Holiday Parking

The city hopes that offering free parking to shoppers on some of the busiest commercial days of the year will give small businesses a lift.
Edit ModuleShow Tags

Hot Reads

Bucket List: 25 Don't-Miss Experiences for the Yinzer in All of Us

Bucket List: 25 Don't-Miss Experiences for the Yinzer in All of Us

You'll have to work hard to make it through the 'Burgh Bucket List — but every entry is more than worth the effort.
Finally Home: How Pittsburgh Won Over Troy Polamalu

Finally Home: How Pittsburgh Won Over Troy Polamalu

Troy Polamalu came to Pittsburgh craving the California sun. Nearly a dozen years later, he shares a rare glimpse of the relationships he developed here — with his God, the Steelers Nation and the city he and his family now call home. One thing is certain: he never wants to leave.
Granting the Perfect Wish

Granting the Perfect Wish

By fulfilling the wish of a 12-year-old boy, PittGirl learns that you don't always need a lot of money to grant the perfect wish.
Men's Winter Fashion: Season for Swagger

Men's Winter Fashion: Season for Swagger

Try an updated take on traditional trends with these winter must-haves for men.
Review: Eighty Acres Kitchen & Bar

Review: Eighty Acres Kitchen & Bar

Farm-to-table restaurant Eighty Acres brings food prepared with finesse to Plum.
Pittsburgh's Top 10: November 2014

Pittsburgh's Top 10: November 2014

Here are the 10 best things to do in Pittsburgh this month.
Edit ModuleShow Tags Edit Module

Edit ModuleShow Tags