Help Dominique (Palmieri Family) Battle Acute Leukemia-ALL

At just 9 years old, on October 21st 2024 our daughter Dominique was diagnosed with Precursor B: Acute Lymphoblastic Leukemia ALL.

In the spring and summer of 2024, Dominique began experiencing daily nose bleeds and a floating pain that would come and go. Throughout the summer she would mention the pain in her ribs or shoulder that would pop up while swimming or biking with her brother saying, "Mama, that pain is back again..."

By August, her pain had intensified so much that she began limping and 6 swollen lymph nodes the size of golf balls popped up on the right side of her neck and collar bone and 3 on top of her head. By the last week of August the fevers were relentless and thus began an endless stream of weekly visits to ER's and doctor's offices that proved useless in helping her symptoms.

As October and Thanksgiving approached Dominique developed pneumonia and mononucleosis and while on antibiotics her fever strangely ramped up even more. Something was wrong. But our concerns as her parents fell on deaf ears as we were constantly told, viral, viral, viral...

Our daughter was deteriorating before our eyes, she had lost 12 pounds, had dark circles under her eyes, was covered in bruises and had only attended about a week's worth of schooling when, finally the week after Thanksgiving weekend we rushed her to Sick Kids as she was not able to open her jaw to take the Children's Advil we had been giving her. They admitted her finally and on Monday October 21st we were told she had Precursor B Acute Lymphoblastic Leukemia ALL.

More than 2 months after her symptoms had begun.

We were in shock, utter disbelief and gripped with every emotion imaginable.

Dominique's pain was so intense she had to be lifted onto a commode to relieve herself and shook in pain, even with pain killers. Her oncologists wasted no time and prepped her to begin chemo 24 hours after her diagnosis. They told us to give the chemo 3-4 days to start bringing down her pain but the shock of our daughter having to take chemo in order to heal her pain left us in the impossible position of heartbreak and anguish; one we have not left since that day on October 21st.

On October 29th we received more news. Dominique's bone marrow aspirate revealed that her gene history has a rare, high-risk, abnormal chromosome that occurs in approximately 2-5% of paediatric patients with B-Cell Precursor ALL Leukemia. This abnormality is associated with a poor outcome for treatment. We were told if this was 20 years ago, it would be a much different scenario for Dominique and because of this, they were altering her road map to include a very aggressive plan. This makes Dominique's treatment extremely intense and very complex.

While the initial treatment for B-ALL in children has high cure rates, a significant portion of children still experience relapse, with rates around 10-15%. We are hopeful that the doctors will treat Dominique to cure, but we have met many families who have not been that fortunate and whose children have suffered one and two relapses, pushing them into second and third line treatment plans. Living with this uncertainty is crippling for us as her parents. Again, we remain hopeful and for now, her body is responding to the treatment.

Dominique's treatment requires round-the-clock, 24/7 care. She has endured countless cycles of bi-weekly lumbar punctures, chemotherapy side affects that burn your skin off, make your hair fall out, cause liver and kidney enzymes to shoot all over the map and chemo side affects that cause excruciating pain in her muscles, jaw and limbs that leave her tired, deflated and depressed. During her first month of treatment Dominique developed medicine-induced Type 1 Diabetes and on top of everything else, was put on a Libre monitor and had to take daily injections of insulin at every meal for a month and a half. She will be required to do this again when steroids are re-introduced later this summer and further down the maintenance line, as her diabetes is expected to return again.

A good portion of children develop long-term, chronic illness after going through cancer and chemotherapy. We have been cautioned that her medicine induced diabetes may become life-long...

Weekly port access is a constant source of anxiety for her where she must work hard to calm her fears just to get through the procedure. And as well as she does, it still gets her every night prior to her access days...

Dominique has had countless red blood cell, platelet and immunoglobulin transfusions to help pull her blood counts up that keep plummeting. Her body is slow at processing chemotherapy which leaves the medicine lingering much longer than it should, causing her blood counts to drop regularly.

She has had a meningitis reaction to an infusion, 3 allergic reactions to medications, blood transfusions and the initial hook up to her immunology backpack (a few firsts that left her medical team at Sick Kids puzzled).

There are non-stop, last minute trips to the emergency room when fevers spike and blood counts drop and she has been admitted more times that we can remember at this point, requiring one of us to be by her side 24/7. Usually, Linda stays with Dominique during the waking hours, while Davide does double duty; working long days at his business and sleeping nights with Dominique in hospital.

Sick Kids has become our home. The onc team of doctors and nurses take wonderful care of her and we are so grateful for them.

On March 26 we got word from Dominique's team that her first year of treatment would be extended from what we originally thought. This was crushing. Meeky's first year of intense treatment will take us to at least, January 2026 - one that began on October 21st 2024. Making the first year duration to last 16 months worth of intense chemotherapy and then followed by 2 years of maintenance.

This has bigger ramifications for our family and taking care of our older son.

Your support will help us do everything possible to ensure Dominique gets everything she needs and aid our family in general during this crisis. Our days are now filled with hospital stays, medical decisions and moments of both hope and grief as we focus on Meeky's fight to beat this cancer.

You support will help our family with:

Medical expenses: support for Dominique's current and future treatments (some of which are not covered by OHIP or Insurance), therapies or anything she may need medically (Dominique is also ASD1 and has ADHD making her particularly sensitive to treatment, coping with an intense needle phobia since little and the loss of control over her body and day-to-day life)

-Demands of Treatment/Daily Life Now: hospital-stay expenses for us, extra needs at home with at least one parent in hospital, transportation costs or other needs for support including for our older child, Andrea

-Time and Flexibility: to allow us to focus on Meeky without financial stress

-The Unknowns: with 10 months more in the first phase of intense treatment and 2 more years to go and all that comes with potential lengthy visits in hospital for Dominique's treatment, we don't know exactly what the future holds yet. Your support will provide security to help us navigate whatever comes next.

With your support and encouragement, you will allow us bit of a reprieve to continue and fight this battle for our daughter. Armed with hope, every amount of love, prayer and well wishes means the world to us. Dominique is a warrior. She says this is her COURAGE ERA. And it is. We are in awe of her, but while we, her parents carry the emotional burden of what she is battling, we know that we are only human and cannot do this alone.

Thank you

Davide, Linda, Andrea & Dominique Palmieri