A 10-year-old girl who battled leukaemia for six years lost her life after developing a transplant complication, an inquest has heard.
Keisha Jade Watson died at the Royal Victoria Infirmary (RVI) in Newcastle after suffering from multi organ failure. An inquest into her death heard how she had been given treatment, including two bone marrow transplants, in an attempt to remove the cancer from her body.
However, she developed Transplant Associated Thrombotic Microangiopathy (TMA), a recognised complication of bone marrow transplant. The condition led to her suffering multi organ failure and she sadly passed away at the hospital on March 19 last year.
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Newcastle Coroner's Court heard how Keisha had been diagnosed with Acute Lymphoblastic Leukaemia in 2015. She underwent chemotherapy and she went into remission, but suffered a relapse in January 2019.
The youngster, from Hartlepool, underwent further treatment, including two bone marrow transplants from donors who were not a match in August 2019 and July 2020. The hearing heard how she then developed the complication.
Dr Su Han Lum, Consultant Paediatric Haematologist at the Newcastle upon Tyne Hospitals NHS Foundation Trust, gave evidence during the hearing on Friday. She told the coroner's court how she had overall care of Keisha at the time of her death.
She explained how treatment was given to patients depending on their risk group and Keisha was classed as high risk.
Dr Lum said Keisha previously needed transplants but she didn't have a donor who was a match. She said that if they hadn't proceeded with the transplant the leukaemia would have been left and she would have died.
The doctor told the court that Keisha was also given expensive treatment which was not available at other units within the UK. She said: "I would like to highlight that she's had the best treatment based on the evidence."
Dr Jan Bengtsson, Consultant Paediatric Intensivist at the trust, also gave evidence. He told the inquest how he had spent the last week of Keisha's life with her in intensive care.
Senior Coroner Karen Dilks asked him: "Was there anything at all that could have been done in terms of Keisha's care that would have altered the care or outcome for her?" He replied: "Not as far as I can see. We have Teams discussions and we were all in agreement that we were doing everything we could."
The inquest heard how Dr Srinivas Annavarapu, Consultant Perinatal and Paediatric Pathologist, examined Keisha's body following her death. He told the court how her blood vessels were damaged and there was damage to her red blood cells.
The court heard how he concluded that Keisha's death was caused by Multi Organ Failure, due to Transplant Associated Thrombotic Microangiopathy, due to Acute Lymphoblastic Leukaemia.
Ms Dilks said she accepted Dr Annavarapu's medical cause of death. She said it was also supported by Dr Lum and Dr Bengtsson, who both agreed with the cause of death.
The coroner gave a narrative conclusion, telling the court: "Keisha died due to natural causes and complications of their treatment."
She said: "Dr Annavarapu clearly identified that Keisha's Acute Lymphoblastic Leukaemia was the significant factor that led to her transplant treatment and it was complications of them them that led to her ultimate death."
Keisha mother Natalie Watson, 38, and her stepdad Ryan Young, 30, are also parents to Kain, 17, Scarlett, six Bella, four, and Ryan, three. They attended the hearing and gave an emotional tribute to Keisha following the conclusion.
Natalie said: "She was amazing, she he was my best friend and she was always by my side. You wouldn't believe we were mother and daughter. She loved doing her nails and her make-up, she was definitely a girly girl.
"I was always in hospital with her. She fought it so many times and it just kept coming back. .Even though she had cancer, she didn't let it beat her. She was so strong."
Keisha was diagnosed with leukaemia when she was four years old after suffering from extreme tiredness. Natalie said: "She kept on saying she wasn't feeling very well and she was sleeping all the time. I got a phone call from a teacher to say she was lying on the teacher's knee and there was an ambulance."
She said Keisha, who attended St Aidan's C of E Memorial Primary School in Hartlepool, was rushed to the University Hospital of North Tees in Stockton and later had her blood taken.
Two weeks later, Natalie received a phone call from doctors at the RVI. She said she was told that an ambulance was on its way and they were taking Keisha into hospital. Natalie said: "I didn't know what it was at that point, they said 'pack a bag, you need to come in.'
Natalie said they wee taken into a room in the trauma area of the A&E and given the devastating news that Keisha had leukaemia. She said: "I passed out. I can't remember a thing after that. I remember waking up at the side of the bed. I was in shock."
Ryan said Keisha always thought of others before herself and even collected around 1,000 selection boxes at Christmas for other children who were being treated at the hospital. He said: "It didn't faze her, she always had a smile on her face.
"Every time we felt upset and down with everything going on we looked at Keisha and we'd think we have no right to feel like that. She used to keep us going, she was a little trooper."
Natalie, who has a necklace which contains Keisha's ashes, said: "If it wasn't for her I wouldn't have got through it. It's hard and the kids keep me going more than anything."
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