ANAHEIM : Marrow Transplant Proceedings Begin

A 16-month-old leukemia patient whose bone marrow transplant was in jeopardy because of state funding rules is settling in at the Seattle hospital where the potentially lifesaving transplant is scheduled for July 15.

Stephanie Rudat of Anaheim was healthy and playful during her first day at the Fred Hutchinson Cancer Research Center, her mother and doctor said Wednesday.

“She’s a beautiful girl,” said attending physician Frank Smith, a pediatric hematologist/oncologist at the Hutchinson Center. “She’s in as good a shape as I could hope to send someone through this procedure.”

Smith and his staff began a series of tests on Stephanie’s blood, organs and lungs yesterday. By next week, she should move up to the 10th-floor transplant center for an intense, seven-day round of chemotherapy and radiation intended to kill all the cancer in her body as well as her own bone marrow, Smith said. Then she’ll be ready for the transplant, a risky operation that doctors say she has a 40% chance of surviving.

“I’m very hopeful, I’m very optimistic, but at the same time, I’m very realistic,” Smith said, explaining that Stephanie could suffer bleeding complications, infection, a rejection of the new bone marrow, or graft versus host disease, in which the bone marrow attacks cells in the patient’s body.

“This is a dangerous thing we’re doing.”

Smith said Stephanie’s age is on her side, but that her medical history increases the risk.

Stephanie was diagnosed with acute non-lymphocetic leukemia when she was 6 weeks old, and has spent most of her life in Children’s Hospital of Orange County.

Last summer she had an autologous transplant, in which her own bone marrow was removed, chemically treated and re-inserted into her body. But she relapsed last October, and doctors have been searching for an outside donor ever since.

This spring, the family passed the $1-million cap on its life insurance and Medi-Cal took over Stephanie’s hospital bills. But the state agency refused to fund an out-of-state transplant because there are California hospitals qualified to do the procedure.

Then, over the weekend, the state agreed to pay for the Seattle transplant from a special fund because officials determined that waiting for a California hospital would not be in the best interest of the child. The transplant will cost about $200,000.