Teen Survivor of T-Cell Acute Lymphoblastic Leukemia Aims High After Stem Cell Transplant  

Nolan Young has aspirations of a career in both the Air Force and FBI, and even at age 15 it’s easy to imagine him achieving these goals. After all, when you’ve already endured the rigors of chemotherapy, radiation, emergency surgeries, and a stem cell transplant for T-cell acute lymphoblastic leukemia (T-ALL) — all before high school — basic training doesn’t seem quite so daunting. 

While facing his health challenges, including numerous side effects and long periods of isolation while immunocompromised, Nolan did more than display toughness and determination. He also learned the importance of teamwork, partnering with his surgical, transplant, and oncology clinicians at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center to overcome each hurdle.  

“When I was in treatment, I developed a lot of appreciation for the doctors and nurses who saved me,” says Nolan. “They were always so helpful and nice to me, it made me want to help others.” 

From the moment of his diagnosis through his initial treatment, relapse, transplant, and recovery, Nolan’s multidisciplinary care team in the Hematologic Malignancy Center at Dana-Farber/Boston Children’s provided comprehensive, seamless care. They stayed in constant communication with Nolan and his family, so that even when his situation took an unexpected and serious turn, they never lost confidence or hope.  

“It was such a huge team involved in the whole process, but we felt very connected to each one of them,” explains Nolan’s aunt, Lisa Chambers. “They were all terrific, and so was Nolan. He just showed so much resiliency.” 

A treatment odyssey 

 An early clue that something was wrong came on Thanksgiving, in 2020. Then 10 years old and usually a voracious eater, Nolan took just a few bites before leaving the table and retreating to the couch. In the days that followed, he became increasingly tired and lethargic. 

This was during the early months of the COVID-19 pandemic, so his aunt suspected that might be the culprit. Nolan never tested positive for the virus, however, and when his fatigue continued along with other symptoms — bone and joint pain, frequent fevers, small red spots on his legs known as petechiae — she grew concerned enough to take him to a local hospital for bloodwork.  

“We were still in the car, driving home, when they called us and told us to go to Boston Children’s Hospital immediately,” recalls Chambers. “They knew that these were symptoms of ALL, and that same night at Children’s it was confirmed.” 

Treatment began immediately, including the family’s introduction to pediatric hematologist/oncologist Angela M. Feraco, MD, MMSc, who explained that Nolan needed to stay in the hospital for four weeks to receive initial chemotherapy. If this didn’t result in complete remission, Nolan would need additional chemotherapy, radiation, and possibly a stem cell transplant. 

“Dr. Feraco was wonderful,” says Chambers. “When you’re just getting situated into Dana-Farber/Boston Children’s, and dealing with the diagnosis and everything that happens next, it can be overwhelming. She was very comforting, including when Nolan ended up needing emergency surgery after that first month of treatment.” 

The surgery was necessitated by an infection that caused a perforation in Nolan’s gut. After the procedure in early January 2021, he was fitted for an ostomy bag he would need to wear for nearly two years. Nolan spent nearly two more months as an inpatient at Boston Children’s, with his aunt and parents taking turns staying by his side. 

“Nolan was released after 70 days on Feb. 22, 2021, his 11th birthday, but even after he got to go home he didn’t stay there too long,” Chambers recalls. “He had a bad reaction to one of the chemotherapy drugs, and started having stroke-like symptoms. We had to call EMS, and at one point he needed a feeding tube. He took it all like a champ.” 

The most serious issue came in April 2021. Nolan’s cancer, put into remission by the initial chemotherapy, had returned.  

“Because of the gut perforation Nolan suffered during that first month, we had to pause his leukemia-directed treatment to allow him to heal,” says Feraco. “We think his relapse was due to this pause, rather than inherent treatment resistance. We were therefore very hopeful that we could still achieve a second, long-lasting remission.” 

Indeed, renewed chemotherapy and total-body irradiation that spring and early summer put Nolan’s cancer back into remission.  

Post-transplant positivity 

By August 2021, Nolan was ready for the next stage of his treatment: a pediatric stem cell transplant led by specialists Christine Duncan, MD, and Helen Reed, MD, MPH. The procedure went well, and during the long post-transplant interval, which included nine months of isolation at home, frequent trips to Dana-Farber for blood work, and several inpatient stays, Nolan impressed the transplant team. 

“He was incredibly inquisitive, thoughtful, and mature for his age, and he always had a story, or three, that made me laugh,” recalls Reed. “If Nolan was scheduled to see me in clinic, I knew I was going to have some hearty laughs. I have no doubt that his attitude — his equanimity, curiosity, and humor — helped him through a difficult time.” 

Nolan says this attitude came about as somewhat of an epiphany. 

“At first I wasn’t sure how to feel, and kept changing how I acted,” he says. “Then it just clicked in my head that I should be as positive as I can. It makes you feel better throughout the whole process.” 

Another central part of Nolan’s recovery, he says, was the love and support of his Aunt Lisa. Reed agrees. 

“She was his rock through it all, always positive but grounded,” says Reed. “I think that she was truly the reason that Nolan could be his calm, curious, and funny self even in stressful times.”  

Because of his weakened immune system, Nolan completed middle school virtually. When he returned to in-person schooling as a high school freshman, he joined the Junior ROTC program to make new friends and rebuild his strength after years spent mostly at home. He also became deeply involved in community service. 

“I don’t really mention what I’ve been through at school, unless I have to for medical reasons,” Nolan says. “I don’t want people to feel sympathetic.” 

These days, Nolan is looking ahead. Inspired by several family members who served in the military, he has his sights set on joining the Air Force straight out of high school, and then studying criminal justice while serving.  He hopes to serve at least 10 years of active duty, and then join the police or FBI while continuing in the reserves for at least another decade. 

To make sure he is healthy as he pursues these dreams, Nolan is seen annually in the David P. Perini Jr. Quality of Life Clinic for survivors of pediatric cancers and the Stem Cell Transplant Long-Term Follow-Up Program at Dana-Farber/Boston Children’s. 

“Nolan’s prognosis at this point is excellent,” says Reed. “There are a number of treatment-related toxicities that are being monitored by his long-term follow-up teams for including hormone deficiencies, low bone density, and cardiac dysfunction, though he has not had significant issues to date. He is also at risk for developing cataracts due to the steroids and radiation he received during therapy, but these can be corrected if they develop.”  

“As far as I’m concerned, Nolan can do anything he wants to do!”