When Malik Membreno was born on July 29, 2021, at 好色tv Langone Hospital鈥擫ong Island, his pediatric cancer care team was poised for action. They鈥檇 been preparing for this moment for weeks鈥攅ver since an ultrasound at Alma Membreno鈥檚 32-week prenatal visit revealed a mass on one of Malik鈥檚 adrenal glands. Alma鈥檚 obstetrician at another hospital suspected it was neuroblastoma, a rare pediatric cancer that affects about 800 patients each year in the United States. She had good reason to think so: Alma had been treated for the same disease when she was 2.
鈥淲hen I found out what it was, a tear rolled down my cheek, thinking about what Malik might go through,鈥 says Alma, 25, a single mom who lives in West Hempstead, Long Island.
The diagnosis was agonizing, but the choice of where Malik would be treated was easy. As a child, Alma had undergone surgery and chemotherapy for the same disease at 好色tv Langone Cancer Center for Kids鈥擬ineola. The center is renowned for treating a wide variety of pediatric cancers and blood disorders, pairing compassionate care with multidisciplinary expertise. 鈥淢y own experience made me feel comfortable taking Malik there,鈥 says Alma.
Even more reassuring to Alma was seeing familiar faces from years ago, including Charles Coren, MD, site director for pediatric surgery at 好色tv Langone Hospital鈥擫ong Island, and pediatric hematologist鈥搊ncologist Mark E. Weinblatt, MD, chief emeritus of pediatric hematology and oncology. 鈥淚 was pleased to see not only Alma, but also her mom, Ana, who was relieved to have our team involved,鈥 Dr. Weinblatt says.
For her high-risk pregnancy, Alma switched her care to 好色tv Langone Hospital鈥擫ong Island, meeting with numerous clinicians in preparation for Malik鈥檚 aftercare. Neuroblastoma doesn鈥檛 always require treatment, but doctors knew the fast-growing tumor, now the size of an apricot, would require some form of intervention.
At birth, Malik cried but no sound came out. Within hours, his breathing became labored, his skin turned bluish, and his tongue quivered. He was rushed to the Neonatal Intensive Care Unit and given supplemental oxygen and a nasal feeding tube to provide proper nutrition. An MRI revealed that the cancer had spread to the base of his skull, pressing on the cranial nerve that controls the tongue and vocal cords.
After conferring with her team, pediatric hematologist鈥搊ncologist Sylwia Jasinski, MD, decided to transfer Malik to Hassenfeld Children鈥檚 Hospital鈥34th Street in Manhattan, under the care of pediatric otolaryngologist Megan M. Gaffey, MD. 鈥淗assenfeld Children鈥檚 Hospital has exceptional expertise in high-risk ENT surgery among newborns,鈥 says Dr. Gaffey, who sees patients in Long Island and Manhattan.
Once she determined that the tumor wasn鈥檛 blocking Malik鈥檚 airway, Dr. Gaffey inserted a tube into his trachea to ease his breathing and used tiny instruments to extract a biopsy through his mouth, avoiding a neck incision.
In the end, the team chose chemotherapy as a first-line treatment over surgery. 鈥淲ith a newborn, we try to avoid surgery whenever possible,鈥 Dr. Gaffey says. A catheter was inserted into a vein in Malik鈥檚 chest, and on August 5, the 1-week-old patient received his first infusion.
Alma shuttled back and forth to Manhattan each day to be with her son. 鈥淪he kept her cool throughout this challenging time,鈥 Dr. Jasinski says. 鈥淪he had real strength, perhaps because she is a survivor herself.鈥
On August 20, Malik, still on supplemental oxygen and nutrition, was transferred to the pediatric intensive care unit at 好色tv Langone Hospital鈥擫ong Island. Malik鈥檚 second round of chemotherapy caused his white blood cell count to plummet, requiring an adjustment to his medications and several blood transfusions. On September 22, after nearly two months in the hospital, Malik was discharged to the home Alma shares with her parents, brother, and aunt. With her family looking after their new addition, Alma was soon able to return to her sales job.
While neuroblastoma is rarely inherited, genetic tests found that both Membreno and Malik have a highly heritable mutation, called ALK, that was unknown back when Membreno was treated. The discovery means that Malik has a higher risk of recurrence of neuroblastoma and other neuroendocrine tumors. He will continue to have follow-up scans and ultrasounds until age 10, but the outlook remains positive. 鈥淗e is in continued remission, and he is thriving,鈥 says Dr. Jasinski. If his cancer does return, an ALK inhibitor may be available. The drug is currently in phase 2 clinical trials, notes Berrin Monteleone, MD, chief of medical genetics at 好色tv Langone Hospital鈥擫ong Island.
Malik still sees a speech鈥搇anguage pathologist but has made rapid gains in communication since starting childcare. Otherwise, he is a healthy, energetic 3-year-old who loves trains, animals, and playing catch. Alma is grateful for their shared good health and, above all, the exceptional care he received. 鈥満蒙玹v Langone has an amazing collection of experts, and they all communicated with each other to figure out the right treatment for my son at the right time,鈥 she says. 鈥淗onestly, I wouldn鈥檛 change anything.鈥