Inside Southern Research’s laboratories, scientists pioneered chemotherapy techniques to successfully battle cancer, discovered seven FDA-approved oncology drugs, and assisted in the development of many other cancer-fighting treatments.

And it was cancer that brought Anna Thompson and her 9-year-old daughter, Lilianna, to Southern Research’s campus in downtown Birmingham one day in August.

Lilianna was just 2 when she was stricken with acute myeloid leukemia, or AML, a form of blood cancer that’s difficult to treat and kills more than 10,000 Americans each year.

Over 16 months of intensive treatments, Lilianna endured rounds of chemo and at one point received fludarabine, one of the anticancer drugs discovered by Southern Research. Today, after a bone marrow transplant, she’s a healthy third-grader at a school in Chilton County.

During their visit to Southern Research, Mrs. Thompson learned about the organization’s decades-long work in cancer research and chatted with oncology researcher Rebecca Boohaker, who is conducting work on AML.

“The visit to Southern Research was awesome,” she said. “I called my mom when we left and said, ‘Lilianna and I got to meet a real-life scientist.’ It’s just great that they are doing cancer research and helping to save lives.”

Southern Research fludarabine
Lilianna Thompson sits between her parents, Anna and Randy, at their home near Clanton. Lilianna’s treatment for leukemia included a bone marrow transplant and a drug discovered by Birmingham’s Southern Research, fludarabine.

Boohaker said Lilianna’s struggle against leukemia represents the driving force behind Southern Research’s multi-faceted efforts to make breakthrough discoveries that improve outcomes for cancer patients.

“It is very motivating as a scientist to see patients’ lives extended by therapies developed at Southern Research. A cancer diagnosis can be devastating, especially when the patient is a child,” said Boohaker, Ph.D., a research scientist in Drug Discovery.

“Meeting such a resilient and positive kid like Lilianna only underscores the importance of the work that we do here in constantly pursuing new therapeutic avenues for treatment for cancers in general, but specifically those that are rare and difficult to treat.”

LILIANNA’S BATTLE

For the Thompson family, the nightmare started in August 2011. At first, it didn’t seem like anything to worry about: Lilianna was running a fever and didn’t have an appetite. Thinking the culprit was a virus, the family headed to the beach for a planned vacation, but Lilianna’s fever wouldn’t break.

A trip to an urgent care clinic resulted in a diagnosis of strep throat. Still, Lilianna wasn’t herself, so the family ended the beach trip to return home. At the pediatrician’s office, the staff was puzzled by Lilianna’s blood tests. They thought the results just couldn’t be correct. But double-checking them with a nearby hospital told a different story.

“The pediatrician came in with tears in her eyes, and I knew that something was wrong,” Mrs. Thompson said.

The leukemia diagnosis on Aug. 19, 2011, was the start of a harrowing journey for Mrs. Thompson and her husband, Randy. That same day, Lilianna was admitted to Children’s Hospital in Birmingham. She didn’t leave until the hospital until late October. Even then, the cancer refused to be beaten.

“AML is the pure devil. It’s extremely, extremely hard to treat. It’s very aggressive. And it’s rare in children. Usually, older people get it, but sadly it’s becoming a lot more common,” Mr. Thompson said.

Acute myeloid leukemia starts in the bone marrow and affects the blood. It’s called “acute” because it progresses rapidly. The American Cancer Society says nearly 20,000 cases of AML are diagnosed each year in the U.S. It’s uncommon in people younger than 45; the average age of an AML patient is 67.

For the doctors at Children’s, the leukemia attacking 2-year-old Lilianna was a stubborn foe.

Southern Research fludarabine
Lilianna Thompson plays with her siblings at the family home near Clanton.

The first round of chemotherapy slowed the disease but didn’t put the toddler in remission. They tried transplanting blood-forming stem cells in an attempt to restore Lilianna’s ability to produce blood and immune cells, but her body rejected the transplant. A second cord blood transplant initially seemed to work, but the AML quickly returned.

Mrs. Thompson said the doctors were running out of options as Lilianna turned 3.

“They said there was not much else they could do, but they were not giving up,” she recalled. “They said, ‘If you’re willing to keep going, we’ll keep going with you.’”

A year had passed since the diagnosis. A new round of chemo was ordered, but Lilianna relapsed after a couple of months. Another disappointment. But then there was a stroke of luck: Around that time, the doctors found a match for a bone marrow transplant that could save her life.

First, though, the doctors would have to stabilize Lilianna so the procedure could take place. She received an even stronger round of chemo and full-body radiation. It took a toll on her. She wouldn’t eat or drink, making a feeding tube necessary. She could hardly get out of bed, despite her mother’s encouragement.

“It was my goal every day to get her up, get her clothes on, and make it through this day,” Mrs. Thompson said.

The bone marrow transplant was completed on Jan. 29, 2013.

“Here we are 5½ years later, and she is thriving. She is just alive and well,” Mrs. Thompson says today. “She is an absolute miracle. That’s what we tell everybody.”

FLUDARABINE

Mrs. Thompson only recently learned that the fludarabine administered to Lilianna during the course of her treatment had been discovered at Southern Research. It was administered in February 2012 as doctors prepared Lilianna for the double cord blood transplant, and Mrs. Thompson credits the drug with helping to keep her daughter in remission before that procedure.

Fludarabine was discovered at Southern Research by organic chemists John Montgomery and Kathleen Hewson in 1968. The U.S. Food and Drug Administration (FDA) approved it for medical use in 1991. (Montgomery was involved in the discovery of four other anticancer drugs.)

Fludarabine is highly effective against chronic lymphocytic leukemia, and it’s used as part of a combination therapy against AML called the FLAG regimen. The drug is also used to combat lymphoma.

Today, fludarabine is on the World Health Organization’s List of Essential Medicines of the most effective and safe medicines needed in a health system. (Another drug discovered by Southern Research, dacarbazine, is also on the WHO list.)

Mrs. Thompson was surprised to learn that a drug used to treat Lilianna was made possible by scientists working just an hour away from the family’s home near Clanton.

“I was just blown away by that,” she said. “It was really neat to find that out.”

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