Logan Kowalski

Through Life’s Uncertainties…Hope Prevails

In November 2019, the Kowalski family was looking forward to the holiday season like most families do. Mom – Jennifer, and Dad – Frank were parents to two healthy children, Alyssa and Logan – children who Jennifer emphatically states, “never got sick.”

“I remember it was right before Thanksgiving and I picked Logan up from school,” said Jennifer. “He looked sick – pale and tired – just not at all like himself. I took him to the urgent care thinking he might have strep. They told me he had a sinus infection and put him on a course of Amoxicillin,” Jennifer said. “One week later, he broke out in a rash from head to toe. They took him off the Amoxicillin assuming he was allergic.” Logan managed through the holiday with no improvement in his symptoms. Soon he developed a fever and Jennifer consulted again with a pediatrician. Following their advice, she alternated Tylenol and Advil to help keep his fever controlled. After two weeks of no improvement and a new development of night sweats, she brought Logan back to the pediatrician for another evaluation and some bloodwork. His EBV antibody test suggested he had had a recent mono infection, so Logan was again sent home with suggestions to “wait it out”. Over the Christmas holiday, Logan continued to feel lethargic and have fever. Jennifer recalls feeling frustrated, but ironically grateful because “we weren’t going through cancer,” she stated. “We had a family friend in our hometown, whose daughter was dying from cancer,” Jennifer stated. “I remember telling Logan that we should be thankful we didn’t have to go through something like that – but that whatever THIS was, we could and should be able to handle,” said Jennifer.

On January 2, more than one month after Logan’s initial symptoms began, Jennifer followed her mom gut and brough Logan to the emergency room at SSM Health Cardinal Glennon Children’s Hospital. Within moments after initial assessment and a baseline set of lab work, Jennifer was told they would be staying the night and admitted for further treatment. “They took me into a room, told me they suspected leukemia or lymphoma and told me he was VERY sick – so sick, that he needed to start treatment immediately,” said Jennifer. “I asked them how I was supposed to explain that to Logan. He could always read my face, and I didn’t want him to feel the fear that I did. I knew he’d have so many questions – questions I wasn’t prepared to answer,” Jennifer said. “I reflected back to the young lady we were praying for. Now that was us – and I knew Logan would remember that.”

Logan DID ask the hard questions. He asked if he was going to die. He was 12 years old, in 7^th grade and was looking at a new way of life that would include more time at Cardinal Glennon than at home for the next 2 ½ years. His diagnosis was Philadelphia Chromosome positive B-Cell Acute Lymphoblastic Leukemia. For the next 30 days, Logan and his mom made the inpatient oncology unit, otherwise known as 4 North, their home. “The first 30 days are known as the Induction phase,” said Jen. “He had horrible anxiety and difficulty with all the pills. The nausea and vomiting were a continual problem for him, but his cancer did successfully go into remission.” Over the next year, the world went through the COVID pandemic, Logan missed all of 8^th grade, and many new friendships were made. “A friend of mine started Team Logan – which has been a massive source of emotional and practical support for our family,” said Jennifer.

Logan started his freshman year of high school (having completed his 7^th and 8^th grade requirements on-line) in Fall of 2021. He was so excited to return to school and somewhat normal teenage life. In December of that same year, Logan had a routine spinal tap during one of his outpatient visits. Following that visit, he and his parents were taking a walk in the park. Jen recalls, “It was an unusually warm day for December, so we decided to take a walk as a family. Ironically, we were talking during the walk about his upcoming bell-ringing ceremony. His nurses and Child Life specialists had encouraged him to begin thinking about it since he was that close to completing his 2 ½ year regimen. My phone rang as we were walking, and I was surprised to see our oncologist’s name pop up. I let Frank and Logan walk ahead of me. I took her call, completely unprepared for the words coming through the phone. She told me she found leukemia cells in his spinal fluid – that his cancer was back, and that we should return to clinic on Monday to discuss a plan.”

That Monday, tears trickled down Logan’s face as doctors confirmed his leukemia recurrence. A bone marrow transplant was the plan for treatment if one of the family members tested positively for a match. When none of the family members did, a decision was made to have Logan go through “intensified intensification chemotherapy” – a highly concentrated and aggressive period of chemotherapy similar to his initial induction regimen but using higher doses, increased frequency and different drug combinations aimed at delivering a powerful blow to the leukemia cells. The major drawback of intensified chemotherapy is increased toxicity and a higher risk of severe side effects, including bone marrow suppression, infections, and organ damage, to name a few. 

Logan spent every holiday that next year in the hospital. The chemo, steroids and radiation took a toll on his body, which had already been fighting so hard. “He will eventually need a double hip replacement and shoulder replacement,” said Jennifer. “Once we get past cancer, we know we’ll have long term effects that we can’t even grasp right now.”

The arduous regimen of treatment forced Logan out of school for his second semester freshman year. He then missed all of his sophomore year and hoped to return for his junior year in fall of 2023. “You watch as your child is pumped with poisons, stuck with needles and given transfusion after transfusion. You watch as their hair falls out and as they are comforted holding their puke bucket. You watch their face and body transformation due to the side effects of their medication. You watch other families on social media going to birthday parties, vacations, arcades and football games and friend outings and your child is quarantined alone and sick. You become friends with other parents whose children are going through cancer treatments, and you watch as so many young lives lose their battle daily – young lives that fought this beast with all of their might. You worry and pray to God over and over to please save your child. You break down almost daily in the shower as part of your ritual to starting another day. When your child finally gets to the part of treatment where they can start to live a somewhat normal life, you constantly worry if this will be the day your child relapses and you have to start this beast all over again. And if you do – you wonder if their body that just went through hell will be able to even handle it again.  The day before MY child was diagnosed, I wasn’t a cancer parent. I didn’t have to worry about any of this. My child became part of the statistics overnight… and unfortunately, cancer does not discriminate.”

Logan returned in fall 2023 to begin his junior year of high school among his classmates. He managed to complete the entire school year and in June, ALSO, quietly “rang the bell” – symbolizing the completion of his therapy. Finally feeling some breathing room, Logan’s family scheduled his Make-A-Wish trip.  They had airplane tickets for July 8, planning to spend a week in Hawaii. On July 5, Logan noticed that he had trouble making certain facial expressions. There was a sudden, unexplained muscle weakness to one side of his face. “I called Dr. Bhatla and she encouraged us to come to clinic. This was the healthiest I had ever seen Logan and he was so excited about starting his senior year. He needed this trip. WE needed this trip as a family. The thought of cancer returning right now was not anything I could stomach as possible,” Jennifer said. A bone marrow biopsy confirmed the recurrence of cancer. The Make-A-Wish trip was cancelled, and Logan’s two options for treatment were CAR-T cell therapy or bone marrow transplant.

CAR T-cell therapy is customized immunotherapy. It’s a genetic engineering of a patient’s own T-cells to recognize and attack cancer cells. T-cells are collected from a patient’s blood, modified in a lab to express a “chimeric antigen receptor” (CAR) that targets cancer, and then reinfused into the patient. The CAR T-cells then multiply, bind to cancer cells, and destroy them. This therapy can provide long-lasting remission for certain blood cancers, such as relapsed or refractory B-cell acute lymphoblastic leukemia and certain lymphomas, where other treatments have failed.

Logan and his family opted for the CAR T-cell therapy in hopes it would not only be effective, but that he might also be able to feel decent enough to complete the academics of his senior year. Between COVID, hospitalizations and side effects of therapy, most of Logan’s high school education had been completed on-line. Despite the atypical and sporadic nature of his attendance, he was determined to graduate and walk with his class. On August 1, 2024, Logan had his first CAR-T cell infusion. In October, he had a second infusion in New York City as part of a study. He tolerated both infusions well and with fewer side effects than the systemic therapy he was used to. He actually felt good enough that he and his finally were finally able to take their Make-A-Wish trip to Hawaii in January 2025, and then two months later, in March, Logan’s cancer came back – a 3rd time.

 “He sat in his room for 4 days. It was impossible to digest. How much more could he take?” Jen recalled. More rounds of chemo began and a bone marrow transplant was planned for the end of May. Unfortunately, that timing meant that Logan would NOT be able to walk with his class at graduation. Whether coincidence or not, there was a situation which kept Logan’s bone marrow donor from being available in May. Transplant date was moved to mid-June and Logan was able to graduate and walk with his class.

Faith has been a steady companion for Logan’s family throughout his entire journey. “God has held us up. Without God, we wouldn’t be here,” admits Jen. “The week before Logan was admitted for transplant, I asked God what we would do….if Logan’s frail body couldn’t handle transplant. On Sunday morning, the day before admission day, I took a walk in the park. While I was there, I saw a woman wearing a shirt that said, ‘I speak the name of Jesus’ and it had the words of that popular song on it.  I was wearing the same shirt, and it had been sweetly given to me by another cancer child’s grandmother. It reminded me to call on Jesus – to access His power and presence for healing and protection. It was a reminder that He has power over all things and that if He brought us TO this – He would bring us THROUGH it.  Logan was admitted to the Bone Marrow Transplant (BMT) unit the morning of June 8. A nurse we had never had before made an intentional point to see me. She told me that in this transplant process, I was likely going to face the fire. She told me when I did – to remember to ‘Speak the name of Jesus’.

Logan had radiation treatments for 5 days followed by high dose chemotherapy for 5 days. The goal of those ‘conditioning’ days is to destroy unhealthy cells, weaken the immune system to prevent rejection, and create space for new stem cells to grow in the bone marrow. On June 18, the night before transplant, Logan went into septic shock. His blood pressure plummeted, he was urinating constantly, and he began having diarrhea, vomiting and fever. He was transferred to the Pediatric Intensive Care Unit (PICU) and within minutes – I faced that fire. An ICU charge nurse sat right next to me in the waiting room, looked me straight in the eyes and stated words I’ll never forget,” Jen said. “Your baby is super sick and we are getting ready to intubate him. There’s not much we can do. He’s in septic shock and the ball is rolling too fast. We have no way to catch it and we cannot do the transplant,” Jen recalled. “I was told to go see Logan and say my goodbyes. I was told that even though ECMO (life support) would normally be a typical next step to save him, it could actually cause him pain and brain bleeds that he would not survive since had no ability to clot his blood.” “As a parent,” Jen said, “I couldn’t believe it had come to this. I pleaded with God telling Him he brought that nurse to me that day to talk about fire. I told Him I was IN the fire. I told Him I was being consumed by the fire. I begged Him to get me out of the fire, and soon after that, two things happened.”

Jen recalls walking from the waiting room to Logan’s bedside. Dr. Bhatla, Logan’s transplant doctor, and Rachel – one of the hospital chaplains – were two of the staff members present as she approached. “I asked Dr. Bhatla if there was ANY hope at all. She told me that there was ALWAYS hope – and to pray and to keep fighting as she was working with the team on a solution. At the same time, Chaplain Rachel uttered words that came flooding back to me,” Jen said. “She told me to speak the name of Jesus over Logan. It gave me chills when she said it, as I remembered both the t-shirt and the radio song; things I had seen and heard just days before we were admitted,” Jen said. Dr. Bhatla advocated to give Logan his donor cells, since they would otherwise be wasted. There was no way of knowing how his body would react, but this was an alternative to the ECMO which seemed impossible for him to survive. She gave the first infusion over 20 minutes then gave the second bag, then the third bag. His heart never stopped. His blood pressure began to improve. It was minute by minute for the next several hours and then he stabilized more and more each day. Her quick thinking and quick action saved my son’s life.”

Logan spent 5 days in the PICU before returning to the bone marrow transplant unit. He remained in the hospital for a total of 60 days. When it was time to leave the hospital, they usually ring a bell. The bell, while special for some people, leaves a really bad taste in Logan’s mouth. He went through a 2 ½ years of treatment and just before ringing that bell had to start all over again when he relapsed. Then after going through another hard-core intensified 2 ½, he finally rang the bell hoping that his cancer journey was over just to have to start all over again, three weeks later. He did not want any part of a bell when he was leaving the hospital from his transplant.  However, Logan’s Child Life Specialist, Allison still wanted him to celebrate such a big step in his treatment. She worked with Friends of Kids With Cancer securing him a Viking horn and a hat to have him walk out of the hospital “in victory”, surrounded by all of his doctors, nurses and therapy team.  

Recovery from transplant continues at home. Strict isolation guidelines and quarantine practice are essential. He has outpatient visits 2-3 days per week to monitor his weight, his blood count recovery, and get in some physical therapy. “He’s on 11 different required medications and has 10 additional medications as he needs them. While eating is still a challenge, he is starting to eat more every day and has thankfully been able to avoid the NG tube since being home, which he desperately dislikes with a passion,” said Jen. “At day 100, he will possibly get to have a friend or two over and possibly be able to go to a restaurant, as long as it is during a time when its non-prime time and quieter, and he might get to see his dogs a little bit.  It is going to be quite a long time before he will get the OK to go to college, parties, events or out with friends. But all of this is ok. The fact that he is here is such a huge blessing and we are just grateful and happy that we get to spend time together. We are blessed that Frank has a good job, and thankful for an amazing community of support that has allowed me to be at every appointment and spend so much time with Logan,” said Jen. “Beyond our HOME community, we’re humbled by those who support the HOSPITAL community. Because of donors, we had services that are so desperately needed for a child to go through the pain and horror of cancer treatments – like the schoolteachers and Child Life.  These special and incredible people are such blessings to our children and our families. They create smiles, remove tears and make it possible and bearable for our children to deal with cancer.”

“I’m scared to be happy that Logan is doing pretty good right now. Five years ago, we weren’t expecting this life-altering diagnosis. We also weren’t expecting that we’d find a whole new family at Cardinal Glennon, an outpouring of love and support from our hometown community, and the incredible bonds of friendship that have evolved as part of this journey. A family culture within a hospital is so important when your family is in crisis. At Cardinal Glennon, everybody knows us and they’re so loving and kind to us. We had the best team of nurses and doctors and therapy staff watching over Logan.  It’s impossible to spend 60 days in a hospital and keep your joy without having the right people bringing you joy and helping you to get through the long days. I also must mention how God has been ever so present in this whole journey. He has never left us at any time.  He has carried us through, and he uses people every day to be his feet and his hands.  Our community, our hospital team, our friends and family, our neighbors – they have all been the hands and feet of Jesus. When we started the bone marrow process, I was terrified, yet God kept showing up in so many ways. On our worst day He showed up and he sat in the fire with us. The day we returned home, I was filled with so much emotion. I was scared that I might miss something; scared that Logan could get sick again. I took a walk that day – and it was a day where there had been absolutely no rain. At the beginning of my walk, I saw a rainbow forming.  By the end of the walk, there was a complete rainbow. I knew that it was God talking to me in a way that only I could understand and telling me that He promises to be there.  He doesn’t promise that every day will be easy, but he promises to be there.

Isaiah 43:2 (ESV) “When you pass through the waters, I will be with you; and through the rivers, they shall not overwhelm you; when you walk through fire you shall not be burned, and the flame shall not consume you”