Anthony S. Stein, M.D., on Craig Sager's Death From Acute Myeloid Leukemia
December 20, 2016 | by Samantha Bonar
TNT's veteran NBA courtside reporter Craig Sager, known as much for his flamboyant suits as his sideline interviews, died on Dec. 15 after a two-year battle with acute myeloid leukemia.
Acute myeloid leukemia (AML) is a fast-growing form of cancer of the blood and bone marrow. It usually occurs in people over age 60 and starts when the bone marrow begins to make blasts, cells that have not yet completely matured. These blasts normally develop into white blood cells. However, in AML, these cells do not develop and are unable to ward off infections.
In this rare disease, the bone marrow may also make abnormal red blood cells and platelets. The number of these abnormal cells increases rapidly, and the abnormal (leukemia) cells begin to crowd out the normal white blood cells, red blood cells and platelets that the body needs.
Symptoms are often described as flu-like and include fever, achiness, fatigue and night sweats. Less than 20,000 people in the United States are diagnosed with AML each year. Prognosis is determined by various factors, but the overall five-year survival rate is 26 percent.
However, according to Anthony S. Stein, M.D., a hematologist and oncologist and co-director of the Gehr Family Center for Leukemia Research at City of Hope, the five-year survival rate for someone over age 65 who is diagnosed with AML is only about 10 percent. Stein was not involved in Sager's care.
The Heart of a Fighter
Sager fought the disease hard, including several rounds of chemotherapy and three bone marrow transplants, the most recent in August.
"It's the determination, grace and will to live he displayed during his battle with cancer that will be his lasting impact,” Turner President David Levy said in a statement Dec. 15.
Sager was initially diagnosed in 2014 and battled the disease publicly. He first received a combination of chemotherapy and a bone marrow transplant from his son, Craig Sager Jr., and was able to return to reporting in March 2015.
However, the cancer soon returned, and Sager underwent several more months of treatment, including a second bone marrow transplant. He was back to work by October 2015, although he made monthly trips to Houston for treatment.
Unfortunately, his leukemia returned yet again. Yet Sager continued to work, juggling treatment through clinical trials. This summer, he was recognized at the 2016 ESPY Awards with the Jimmy V Perseverance Award, delivering a moving speech about his cancer fight and his determination to savor every moment he had left:
“Whatever I might have imagined a terminal diagnosis would do to my spirit, it’s summoned quite the opposite: the greatest appreciation for life itself. So I will never give up, and I will never give in. I will continue to keep fighting, sucking the marrow out of life as life sucks the marrow out of me.
“I will live my life full of love and full of fun. It’s the only way I know how.”
A Third Transplant
The following month, Sager underwent a third stem-cell transplant, which took more than 10 hours to complete.
It’s very rare to have three transplants, according to Stein, who said that usually the maximum number is two, because the treatment is so grueling. “If he had three transplants he probably had a very aggressive type of AML,” he said. “It’s difficult for a person to withstand a third transplant.”
But Sager was determined to keep trying.
“Man, life is too beautiful, too wonderful, there’s just too many things,” he said. “It’s not just you. It’s your family and kids and all. Fight. Fight until the end. Fight as hard as you can.”
In the end, that third transplant bought Sager another four months.
“If you look at outcomes in patients over age 65, not too much progress has been made,” Stein said of Sager. “However, some exciting new therapies are in the works," and “some new drugs are coming along that may be more tolerable.”
City of Hope is involved with clinical trials of some of these new treatments, including one that directly targets the genetic mutation that causes the leukemia. Another novel treatment involves attaching chemotherapy to a specific antibody that carries it directly to the cancer cells. A third therapy, called CAR-T cell therapy, stimulates the body’s own immune system to attack the cancer.
“I think these are all promising treatments,” Stein said, noting that some are further along in development than others. He said he is confident that “within the next four to five years, we should have some newer, better treatments that should improve outcomes.”
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