Insurer Will Pay for Girl’s Operation After All : Transplant: Aetna reverses its decision not to cover a bone-marrow procedure that could save a 5-year-old cancer patient’s life.

The insurance company that had refused to pay for a bone-marrow transplant for 5-year-old cancer patient Holly Keuthan reversed itself Monday and announced that it will pay for the $350,000 operation, which could triple the girl’s chance of survival.

“The case went through another extensive review, and we decided to proceed with it,” said Aetna Life Insurance Co. spokesman Robert Nolan in an interview.

Aetna medical directors decided to review Holly’s case again last week after several people asked the company to look into the family’s file, Nolan said. The payment was approved Monday, and the family was notified by Aetna’s San Diego office in the afternoon.

“This is just wonderful,” said Karen Keuthan, Holly’s mother. “I have renewed faith in people. I’m sorry we had to spend so much effort in this. It seemed never-ending.”

The Dana Point girl suffers from Ewing’s sarcoma, a cancer that has settled into her right leg and spread to her lungs. A bone-marrow transplant would allow higher dosages of chemotherapy to kill the cancer cells.

With regular chemotherapy, Holly only has a 20% chance of beating the disease, her doctors say. But with the aggressive chemotherapy, her chance jumps to 60%.

Despite a personal appeal by Dr. Mitchell Cairo, Holly’s physician and director of Children’s Hospital Bone Marrow Transplantation Division, Aetna had refused to pay for the operation, saying the treatment was considered experimental. However, the family went ahead and asked the hospital to proceed with harvesting Holly’s bone marrow for future use.

That bone marrow will be stored while Holly undergoes the intense chemotherapy. The marrow will later be reintroduced to help her battle the chemotherapy’s effects.

Since Aetna’s refusal in January, the Dana Point family has been scrambling to raise money for the operation and the chemotherapy, which costs seven times the family’s annual income. Family friends even started a trust for Holly, and there were plans for fund-raisers and donation drives.

For the past few months, parents Jan and Karen Keuthan have been waging a letter and telephone campaign to persuade the insurance company to reverse its decision. Aetna officials told the family that the procedure does not have a “track record” of successfully treating Ewing’s sarcoma. Because there are no government guidelines on what is considered acceptable medical treatment, insurance companies have to determine for themselves what is experimental and what is not, insurance experts say.

According to Aetna’s guidelines, a bone-marrow transplant combined with aggressive chemotherapy is not considered acceptable treatment for Ewing’s sarcoma, even though it is considered appropriate for other illnesses.

Nolan refused to say why company officials changed their minds about Holly’s case, but he said the company will continue to look at experimental treatments case by case.

“This case was reviewed, and on its merits, it was approved,” Nolan said. “There are no assurances for future ones.”

With Aetna’s turnabout, Holly now faces two more chemotherapy treatments and then the operation itself.

But on Monday, the Keuthans said they would celebrate. They planned to go out to dinner, a luxury that was unthinkable when they were saving all their money for the operation.

“I’m placing my faith in her doctor and the bone-marrow transplant,” Karen Keuthan said. “This is going to give her that extra chance, that edge she deserves.”