Pierce Estremo is an unstoppable boy. The 7-year-old from Livermore, California, is constantly on the move—riding bikes, playing baseball and soccer, and exploring the outdoors. He’s always looking to make a new friend, and with his bright eyes, big smile, and larger-than-life personality, it happens easily.
“He’s such an active, happy kid. No one would ever know he had leukemia and spent six months in the hospital,” says his mom, Meredith.
In July 2022, Pierce started feeling ill. He had an ear infection and pain in his lower back that made it hard to get through the day. Little did the family know when they took him to the pediatrician that their world was about to change drastically.
“Our pediatrician said his test showed signs of blood cancer and we needed to immediately go to a nearby hospital to learn more,” Meredith says.
Carefully weighing where to receive care
The family came to Stanford Medicine Children’s Health, where pediatric oncologists in the Bass Center for Childhood Cancer and Blood Diseases confirmed that Pierce had leukemia.
Leukemia is a cancer of the blood that develops in the bone marrow, the place where white blood cells—the immune cells that help fight infection—form. With leukemia, the bone marrow makes abnormal white blood cells that crowd out functioning, normal cells. Specifically, Pierce had acute myelogenous leukemia (AML), the second-most-common type of leukemia in children, accounting for 17% of cases.
“Those first several days at Stanford Children’s were crucial and fast, and we had to make big decisions,” Meredith says.
She and her husband, Peter, carefully weighed whether they should stay at Stanford Children’s or go to another Bay Area hospital. They called on friends in the medical arena for advice, read reviews, and researched clinical trials. They also spent a lot of time discussing their choice with the Stanford team.
“The Stanford Children’s team stayed with us through the night reviewing our options. They even set up an interview with another hospital to discuss their clinical trials because they knew it was one of the biggest decisions of our lives,” Meredith says. “In the end, we chose Stanford because of its great reviews and AML clinical trials. But mostly because we immediately felt such comfort and love from the medical team.”
Going through four rounds of chemotherapy
Once the decision was made, the team quickly determined the best course of chemotherapy for Pierce and began it within three days. Acute myelogenous leukemia comes on quickly and can get worse if not treated right away.
“‘Acute’ means it emerges in weeks or months, and it’s a disease we can cure. We don’t cure everyone, but it is a curable disease,” says Norman Lacayo, MD, a pediatric hematologist-oncologist at Stanford who treated Pierce.
Chemotherapy is a group of medicines that kill cancer cells by making it hard for them to grow or reproduce. It’s often the first treatment for acute myelogenous leukemia.
“AML therapy is very intense. It can come with several complications, and parents are on pins and needles the whole time,” Dr. Lacayo says. “Meredith and Peter are very smart. They knew exactly what we were dealing with and the risks of the therapy.”
Pierce spent six tumultuous months completing four rounds of chemotherapy in the hospital. His parents took turns caring for their daughter at home and staying at Pierce’s bedside.
“It was truly teamwork with his parents, and they were very good teammates,” Dr. Lacayo says. “He responded very well to the first course of chemotherapy. We assess the response by looking at minimal residual leukemia in his blood, and there wasn’t any.”
To ensure that the leukemia was completely wiped out, Pierce finished his rounds of chemotherapy.
Chemotherapy doesn’t attack just cancer cells; it also kills healthy cells. For Pierce, this led to dangerously low levels of white blood cells after each round of chemotherapy. He developed a condition called neutropenia. Neutropenia can come with high fevers, chills, and sweating.
At one point, Pierce developed typhlitis, an inflammation in the large intestine that can accompany a weakened immune system. He couldn’t eat or drink on his own for a month.
Finding time to just be a kid
Even through the ups and downs of intense chemotherapy, Pierce found time to play while staying at the hospital. When his white blood cell counts were high enough to protect him from possible infection, he would make friends in the playroom, visit the gift shop, and cruise his remote-control cars around the atriums and hallways.
“He was a very popular boy. He would walk down the halls and engage the staff in conversations. He is not shy at all, and he exudes joy and a positive attitude,” Dr. Lacayo says.
Pierce inspired fun wherever he went. At Thanksgiving, he expressed his wish to run in a turkey trot as his mom once had, and the nurses got busy and created a turkey trot around the fifth floor, hanging signs and decorations, cheering on the racers, and handing out trophies.
Pierce also took advantage of Sophie’s Place Broadcast Studio at Stanford Children’s and hosted televised shows with his care team. In one, he gave a remote-controlled car review, and in another, he organized a sour candy challenge.
“For a moment in time, Pierce became a figurehead at Stanford,” Meredith says. “His memories of Stanford Children’s are positive. He remembers the people and things he did, and he is quickly forgetting the hard times.”
Meredith and Peter were thrilled that Pierce, when he felt well enough, could just be a kid and do kid things. They appreciated how Stanford Children’s cares for the whole child, going well beyond stellar medical care.
“We tried to keep it fun, and the nurses and doctors did the same,” Meredith says. “Because of all the resources available to us, we had a wonderful experience in the darkest time of our lives.”
The family also took advantage of music therapy, art therapy, and the Hospital School, which kept Pierce on track academically with one-on-one instruction.
Checking items off his bucket list
Luckily, chemotherapy worked for Pierce just as it should—wiping out all traces of leukemia cells in his body. On the day of discharge, the halls were packed to watch Pierce “ring the bell”—a ceremony where the care team lines the hallway and cheers as a child rings a large bell to celebrate going home.
“Pierce is most likely cured—his chance of recurrence is low, since his leukemia was low-risk,” Dr. Lacayo says. “It’s wonderful to see him thriving.”
It’s been eight months since Pierce completed treatment, and his three-month checkups have shown zero residual disease.
This past summer, Pierce spent his days ticking off items on his bucket list—something his parents created to help him through treatments. He’s already taken a ride on his neighbor’s boat and ridden his bike at the BMX track. The family hopes to soon check off his biggest wish: a trip to Hawaii for surfing lessons and an ATV tour.
“Pierce has transformed back to how he looked before, and he acts like nothing happened. We feel very lucky and filled with gratitude for the care and teams that supported us at Stanford,” Meredith says.
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