CARMEL — Inside a bright clinic at Riley Hospital for Children at IU Health North, Teagan Riley’s morning began like any routine checkup: a quick temperature, a height and weight, a blood‑pressure cuff that puffed up and let go. But this was no ordinary appointment. The waiting room thrummed with family chatter, banners and streamers hugged the walls, and the air shimmered with tears — the joyful kind. Hope, in this case, was audible as much as visible.
5‑year‑old Teagan walked with her family to the bell used at Riley to mark the end of cancer therapy. Before she rang the bell, her 8‑year‑old sister, Skylar, read aloud: “ring this bell, three time well. It's toll to clearly say: my treatment's done, this course is run, and I am on my way.” Skylar’s voice broke on the last line; the room held its breath and then celebrated.
Teagan was diagnosed with B‑cell acute lymphoblastic leukemia when the family at first assumed she had ordinary childhood complaints. Santana Riley described the early days by saying, “A lot of her symptoms were just kind of kid-related symptoms like bruising, fatigue and leg pain. Then I felt like it got to a point where it was past normal.” The family said they even made appointments for other things to have her checked out. "Leukemia definitely wasn't something that entered our minds,” Adam Riley said.
“How do I protect my daughter at that moment? It's hard to even think about what the treatment's going to be,” said Adam Riley, Teagan’s father, recalling the moment they learned the diagnosis. The family’s connection to Riley runs generations deep — Adam was treated there as an infant for a congenital heart defect — and that history helped shape their trust in the care team.
“So when our patients present with leukemia, the most common type that we see is B-cell acute lymphoblastic leukemia, which is what Teagan has,” said Dr. Rachael R. Schulte, a pediatric hematology‑oncology specialist at Riley. “At the very beginning, we do a lot of testing to try to figure out the best long‑term treatment plan for them. So once we set Teagan on that treatment path, it's generally between a 2 and a 2.5-year journey.” She said families move from an intensive early phase to a maintenance period often managed at home and added, “Very optimistic that now that she has completed her treatments that she will remain in long‑term remission.”
Schulte spoke directly about the broader picture for pediatric leukemia and outcomes: “She [Teagan] is in a group that we expect to have long-term relapse-free survival of above 95%, probably closer to like 98%.” She also urged parents to trust their instincts: “Fortunately, cancer in general in children is really rare. Leukemia is something that the symptoms can be pretty vague. I always encourage parents, if you feel like something is off with your child, just continue to advocate.”
How common is childhood cancer — and leukemia?
The National Cancer Institute (NCI) states, Childhood cancer is rare but remains a leading cause of disease‑related death among children.
The CDC estimates that roughly 15,000–16,000 children and adolescents younger than 20 are diagnosed with cancer in the United States each year. Acute lymphoblastic leukemia, or ALL, is the most common childhood cancer and accounts for about three‑quarters of pediatric leukemias; leukemias overall make up roughly 30% of childhood cancer diagnoses.
Among children with ALL, approximately 98% attain remission. Approximately 85% of patients aged 1 to 18 years with newly diagnosed ALL treated on current regimens are expected to be long-term event-free survivors, with more than 90% of patients alive at 5 years, NCI data show.
Survival rates have improved dramatically over the decades because of advances in therapy and broad participation in clinical trials. For many children with favorable B‑cell ALL, long‑term, relapse‑free survival rates now exceed 95%. Still, experts say vigilance and follow‑up are important: children who finish therapy are monitored for recurrence and for possible late effects of treatment, Dr. Schulte stated.
What parents should watch for:
Leukemia symptoms can be vague and overlap with common childhood illnesses. The American Cancer Society urges parents to consult a pediatrician if a child has persistent or unexplained signs such as:
- Ongoing fatigue or pallor
- Unusual or easy bruising and bleeding, including frequent nosebleeds
- Recurrent or prolonged fevers or infections
- Bone or joint pain (young children may complain of leg pain)
- Swollen lymph nodes, abdominal swelling or unexplained weight loss
- Petechiae — tiny red or purple spots on the skin that don’t fade when pressed
“These things can overlap with milder illnesses,” Schulte said. “But parents know their kids best. If something feels wrong, say so.”
Small moments, big meaning through months of clinic visits, blood draws and spinal taps, the Rileys tried to keep a normal childhood life within reach. Skylar described games she and Teagan invented in the basement and told her sister plainly: “You are amazing because you just went through a lot.” Santana said the family leaned on faith and the small happy moments: “There are going to be dark days. Don’t lose your joy.”
After the bell sounded and the hugs and applause began, the family’s celebration was delightfully simple: McDonald’s, a stop at Chick‑fil‑A and a long playtime at the playground. Teagan, who spent half her young life confronting a disease most children never face, is now in remission, and her medical team said they are hopeful she will remain so.
For clinicians and families, a child ringing that bell is an unmistakable reminder that hard seasons can end, that resilience can be ordinary in the life of a child, and that hope can be felt as much as seen in a waiting room full of streamers and family.
