Jake Schapansky holds his daughter, Avry Jo, while ringing the bell to signify the end of cancer treatments for Avry Jo. Mom, Rose, and brother, Trace, celebrate along with Dr. Shannon Cohn and Dr. Amir Mian. Avry Jo is the first child treated with a stem cell transplant at Dell Children’s Medical Center.
Sara Diggins/Austin American-Statesman
Avry Jo Schapansky has made it. On Aug. 7, the 5-year-old from Bastrop, dressed in a pink princess dress with silver sparkly shoes, completed 18 months of cancer treatment, including two stem cell transplants to treat neuroblastoma.
Last August, she became the first person to undergo a stem cell transplant at Dell Children’s Medical Center in Austin as part of a new program that launched with Avry Jo’s treatment. A year later, Dell Children’s has completed six stem cell transplants in three patients, with a fourth patient now in the hospital preparing for the first of two transplants.
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A Dell Children’s team member holds a card for Avry Jo Schapansky as the Schapansky family celebrates the success of her stem cell transplant treatments.
Sara Diggins/Austin American-Statesman
Jake Schapansky holds his daughter, Avry Jo,while the family, including mom, Rose, and brother, Trace, celebrate the success of the 5-year-old’s stem cell transplant treatments for a neuroblastoma. Attending the bell-ringing ceremony were her doctors, Dr. Shannon Cohn and Dr. Amir Mian, at Dell Children’s Medical Center. Avry Jo is the first child treated with a stem cell transplant at Dell Children’s.
Sara Diggins/Austin American-Statesman
In her father’s arms and surrounded by family and friends dressed in pink — her favorite color — Avry Jo had her father ring the bell to mark the end of her cancer treatment. Her mother, Rose, and brother, Trace, celebrated with her, as did the doctors, nurses, coordinators and therapists who treated her. Fellow cancer patients and their families also joined.
Avry Jo impressed the team with her tenacity. When her nasal feeding tube fell out recently, she resisted any help from the nurses and put it back in herself, threading it through her nose down to her esophagus into her stomach.
Dr. Shannon Cohn embraces Rose Schapansky during the ceremony to declare Avry Jo’s treatments over.
Sara Diggins/Austin American-Statesman
“Her fight is what got her through it,” said her mother.
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That strength and passion “is why we are here today,” said Dr. Shannon Cohn, who is part of the stem cell transplant program at the hospital.
Avry Jo is now considered cancer-free, said Dr. Amir Mian, the head of the stem cell transplant program at Dell Children’s. She will be monitored with monthly with blood draws to check for any signs of recurrence. Neuroblastoma is a highly aggressive cancer that develops from immature nerve cells. It typically occurs within the first few years of life and once had a 30% survival rate. It now has 70% or greater survival rate because of bone marrow transplants and a new treatment protocol.
Jake Schapansky holds his daughter, Avry Jo, during the celebration of the 5-year-old’s stem cell transplant treatments.
Sara Diggins/Austin American-Statesman
A long time coming
Dell Children’s did not have a stem cell transplant program when it was built in 2007, but that was always the plan. The hospital initially promised to launch a bone marrow transplant program in a year, but that got put on the back burner.
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Dell Children’s did not have the infrastructure or the physical layout to successfully start the program. A few developments had to happen:
Dr. Amir Mian speaks with ceremony attendees. He was brought to Dell Children’s Medical Center to start the stem cell transplant program.
Sara Diggins/Austin American-Statesman
Dell Medical School at the University of Texas had to open in 2016. Without a medical school, it would be difficult to attract the doctors and specialists needed to launch the program.
Dell Children’s had to build an area of the hospital with specialized airflow to maintain a sterile environment and keep viruses and bacteria out. When the hospital built the fourth tower in 2022, it created eight rooms with the correct ventilation for stem cell transplant patients.
Dell Children’s had to recruit the team. That started in 2023 with the recruitment of Mian to lead the program and later two additional doctors. The hospital also recruited coordinators to manage the program and trained nurses with advanced certifications, specialized pharmacists, psychologists and child life specialists in transplant care. “It takes a team,” Mian said.
Dell Children’s had to go through ongoing regulatory compliance and certification steps to perform the transplants. “It’s quite a strenuous process,” Mian said of the accreditation. “Every transplant program is very expensive and resource intensive.”
Rose Schapansky celebrates with her daughter’s care team.
Sara Diggins/Austin American-Statesman
During the accreditation process, hospitals begin with autologous bone marrow transplants, which use the patient’s own stem cells. The hospital initially has to pay for the cost of the treatments because they are not covered by insurance until the program is fully accredited, typically two years after it starts, when it can show long-term results. Once fully accredited, Dell Children’s will be able to do allogeneic transplants, which use donor stem cells, as well as gene therapies and CAR T-cell therapies. Mian expects allogeneic transplants to begin next year and the others to happen in 2028.
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Typically, 15 to 20 local patients at a time travel elsewhere for these treatments that Dell Children’s doesn’t offer yet, Mian said.
Avry Jo Schapansky shares a moment with her dad, Jake, at the blood and cancer treatment center at Dell Children’s Medical Center.
Sara Diggins/Austin American-Statesman
Seeing the results
Avry Jo was 3 when she was first diagnosed in March 2025. Her family then had a choice: travel to Houston, Dallas or San Antonio for the stem cell transplants or take a chance on a new program and a new team at Dell Children’s. The second choice would allow the family to not have to separate with one parent away with Avry Jo and another home with Trace for months at a time.
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Being able to stay home was the main reason the Schapanskys agreed to have Avry Jo be the inaugural patient, Rose Schapansky said.
Avry Jo’s stem cells were harvested from her bone marrow in May. After rounds of chemotherapy to kill off the cancer cells, the stem cells were put back into Avry Jo in August and again in October. The protocol for neuroblastoma is two rounds of stem cell transplants with chemotherapy, then radiation, immunotherapy and surgery to remove any dead cancer cells.
The family went to Dallas in December for the radiation portion, but that was only for three weeks, which felt more doable. Eventually, Mian said, Dell Children’s will provide radiation treatment after it builds out the rest of the program.
“We have so much gratitude for them to put their trust in our team,” Cohn said.
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Avry Jo Schapansky, 5, smiles with her friends and family as the Schapansky family celebrate the success of her stem cell transplant treatments for a neuroblastoma with a bell-ringing ceremony at Dell Children’s Medical Center. Schapansky is the first child treated with a stem cell transplant at Dell Children’s.
Sara Diggins/Austin American-Statesman
These past 18 months have not been easy for the Schapanskys, but Rose Schapansky said the care they got felt very personal because of the size of the program.
They kept Avry Jo motivated by doing crafts in the hospital. “When she would be feeling terrible, she would still sit up and do crafts,” Rose Schapansky said. The family ended up with three tote bags full of her crafts, which she hung around her hospital room and handed out to every team member: bracelets, drawings, paintings and more.
The family had a mantra: “We can do hard things.” When Avry Jo would be struggling, her mom would say, “We can do” and Avry Jo would answer “hard things.”
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The light at the end of a very dark tunnel
In the past few weeks since treatment ended, the Schapanskys have seen their daughter’s personality return, Rose Schapansky said. “We’re seeing her do things she hasn’t done in 18 months.”
She’s more carefree, and there’s a light in her eyes again.
During the bell-ringing ceremony, Avry Jo and her family arrived by stretch SUV limo at the blood and cancer center next to the hospital to fulfill one of Avry Jo’s wishes. They handed out pink thank-you bags to all of the team members and planned an 80-person party back at home that same day.
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“We would tell anyone to come here,” Rose Schapansky said. “You get personalized care.”
“Very personal,” said dad Jake Schapansky.
“We love you all so much,” Rose Schapansky said, but then, jokingly, “But we can’t wait to get out of here.”
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