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UC Davis Comprehensive Cancer Center

UC Davis Comprehensive Cancer Center

Titus Chang — A Miracle Match

Titus and Jedidiah Chang

Eighteen-month-old Titus Chang had black and purple bruises all over his body, and a nose bleed that soaked a bath towel. Sandy and Lee Chang rushed their baby to a Stockton, Calif. hospital.

It was no simple nose bleed; the toddler was turning purplish and pale, and the situation was life threatening.

Hospital nurses told the Changs their baby needed a higher level of care, and Titus was taken by ambulance to UC Davis Medical Center, where doctors suspected he had a form of leukemia. There Douglas Taylor, a pediatric hematologist-oncologist, later diagnosed him with aplastic anemia, a condition where the bone marrow produces insufficient blood cells. It was 2003.

Aplastic anemia is rare in children and more commonly diagnosed in older people with weakened immune systems. After three days at the hospital and weary of her son’s misery, Sandy Chang grew skeptical about the diagnosis and wanted to take her son home.

Sandy Chang remembered Taylor telling her, “If you take him home, he’s going to die,” and urged her to allow them to give him blood transfusions, as his bone marrow had stopped producing new blood cells.

Taylor told the Changs to watch for symptoms such as pale skin, loss of appetite and lethargy. At home, Sandy Chang was alarmed at her son’s greenish pallor and brought Titus back to the UC Davis Medical Center’s pediatric infusion center.

Sandy and Titus ChangThat began a regimen of three blood transfusions every week, each lasting up to eight hours. Titus also needed platelet transfusions to help his body fight germs. Titus could only be given filtered blood because he was so vulnerable.

“How will Titus get better?” Sandy Chang asked Taylor.

Taylor explained to the Changs that their child would require a bone marrow transplant from a suitable family member. A sibling would have a one-in-five chance of being a perfect match.

“Are you saying that I have to give birth to up to five kids to save Titus’ life?” she asked. Taylor said yes.

As it turned out, Sandy Chang early in pregnancy with a second child. Titus’ future sibling, who would be named Jedidiah, had the potential to save his brother’s life.

But the anticipated newborn baby would face tremendous risks as an infant bone marrow donor. Taylor suggested instead a transplant of Jedidiah’s umbilical cord stem cells.

Jedidiah’s umbilical cord stem cells were collected during delivery and kept frozen until doctors could determine whether they could be used for Titus.  The brothers, it turned out, were a perfect match.

Prior to the transplant, Titus’ defective bone marrow was destroyed with a week of radiation treatments.
“They shut his whole immune system down,” said Sandy Chang, “That way they could reboot him, and give him whole new cells.”

Nurses placed a catheter near Titus’ heart for the transplant, and then kept a close watch to ensure that the toddler was growing normally and not rejecting his brother’s cells. Titus spent three months in the hospital and was isolated at home for a year.

Titus was like a newborn baby again, recalled Chang. His development has progressed normally ever since. Sandy Chang said her son’s school teachers can’t imagine Titus as anything but the vibrant and healthy child they see in class every day.  The scar left from his catheter incision proves otherwise.

Sandy Chang gave birth to two girls and another boy, making sure their umbilical cord stem cells were collected and stored. The Changs are grateful to have been blessed with a large family, and are equally grateful to the cancer center faculty for saving their son’s life.

 “I would do anything to help UC Davis,” she said, “I don’t know what I would have done if I had lost my only child at the time.”

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