Leila Suyapa Macy spent two months fighting severe physical symptoms—intense leg pain, frequent vomiting, and an extreme intolerance to food odors—before a March 2025 medical evaluation at the Baptist Health Herbert Wertheim Cancer Institute delivered a stark diagnosis: Philadelphia chromosome-positive B-cell acute lymphoblastic leukemia.
A Fast-Growing Blood Cancer Driven by an Abnormal Gene
The 57-year-old Miami resident faced a fast-growing cancer of the blood and bone marrow. In this specific leukemia subtype, cancer cells carry the abnormal BCR::ABL1 gene, which produces a protein driving rapid cancer cell growth. Firas El Chaer, M.D., hematologist-oncologist and chief of Leukemia and medical director of Infusion Services at the institute, notes that Ph-positive ALL has historically carried a higher risk of relapse. Modern clinical assessment evaluates risk dynamically based on how quickly and deeply a patient responds to targeted treatment.
Replacing Intensive Chemotherapy With Precision Drugs
Her medical journey illustrates how modern precision oncology combinations replace intensive conventional chemotherapy for high-risk leukemia subtypes. Treatment departed from conventional high-intensity chemotherapy by utilizing precision oral medications and continuous intravenous immunotherapy infusions.
Ms. Macy’s regimen included sequential targeted drugs designed to block the abnormal BCR::ABL1 protein, starting with imatinib, transitioning to dasatinib, and later shifting to ponatinib following gastrointestinal complications.
Managing Immunotherapy and Temporary Complications
Her care plan also incorporated blinatumomab, an immunotherapy administered via continuous intravenous infusion that directs the patient’s immune system to identify and destroy leukemia cells.
During her initial blinatumomab infusion, she experienced chills, facial flushing, heart palpitations, and leg pain, prompting care teams to temporarily halt the infusion, administer symptom-control medication, and safely resume treatment once symptoms subsided.
Complete Molecular Remission and Return to Work
Monitoring through serial blood tests, bone-marrow examinations, and sensitive molecular assays confirmed the efficacy of Ms. Macy’s treatment plan. Her post-treatment bone-marrow biopsy demonstrated normal blood-cell production devoid of immature leukemia blast cells. Specialized testing detected no measurable residual disease, confirming the complete absence of microscopic cancer populations.
According to Dr. El Chaer, the complete disappearance of the BCR::ABL1 molecular marker indicates a highly favorable clinical response. Following her recovery and several months of specialized cancer care, Ms. Macy returned to her work earlier this year, marking a successful milestone after spending a year away from her career.
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