Before two of her daughters were diagnosed with cancer, Andrea Richmond had long dark hair and a winning smile.

The smile is still there, but a wig has replaced her hair, and she's also lost her eyebrows and eyelashes. Her hair fell out earlier this year, she suspects, because of stress related to her daughters' life-threatening illness.

Sydney, 4, and Lauren, 2, both have acute lymphoblastic leukemia, an "extremely unusual" occurrence among siblings who are not identical twins, said their physician, Dr. A. Kim Ritchey, chief of pediatric hematology-oncology at Children's Hospital.

Dr. Ritchey said an investigator in Denmark had identified 40 to 50 sibling pairs worldwide who are not twins but have the same disease. The girls' father, Dr. Jeff Richmond, a pathology fellow at the University of Pittsburgh Medical Center, said he found even fewer cases in published studies.

		Blood drive The Central Blood Bank is holding a blood drive on behalf of Sydney and Lauren Richmond on Friday from noon to 6 p.m. at Bible Baptist Church, 2721 Rochester Road, Cranberry. To schedule an appointment to donate blood at this event, call the blood bank at 412-209-7067.

Sydney and Lauren, who live in Cranberry with their parents and younger sister Tessah, 7 months, both have endured many trips to Children's for bone marrow tests, infusions of blood products, and chemotherapy, including steroid treatments. Side effects of therapy and other problems have required frequent trips to the emergency room.

"We have our good days and bad days," Dr. Richmond said. "Overall, we try to stay as positive as we can."

When she came to Children's for treatment last week, Sydney was apprehensive as she waited for a chemotherapy session that was to include a spinal tap. She had forgotten her "Courage Bear," a blue stuffed bear she often turns to for comfort, and was diverted by donated holiday gifts of plastic zoo animals and a stuffed penguin presented by the hospital staff.

The treatment never took place, however, because her blood counts were low and she needed an infusion of red blood cells. The three girls, their mother and grandmother, Linda, ended up staying at the hospital all day.

The most common leukemia in children, acute lymphoblastic leukemia, appears most often in children younger than 10, according to the National Marrow Donor Program. About one-third of cases, however, are in adults. Nationwide, about 4,000 new cases of the disease occur each year.

In people with the disease, abnormal white blood cells known as blasts multiply rapidly and crowd out normal cells in the bone marrow. The disease can be fatal in weeks or months if left untreated.

Symptoms can include weakness, fatigue, fever, infections, weight loss, excessive bruising, breathlessness, bone or joint pain and enlarged lymph nodes, liver or spleen.

Patients often receive an intense regimen of chemotherapy for the first four months, followed by a less rigorous phase of treatment that may last two or three years. Many receive chemotherapy through a spinal tap to kill any cancer cells that may have spread to the brain and spinal cord.

In some patients, a bone marrow transplant or cord blood transplant may be a good option for long-term remission.

For children, the overall survival rate after chemotherapy is 80 percent. But Dr. Ritchey noted that rates vary depending on individual characteristics of the patient and the disease.

Sydney and Lauren have a good prognosis, he said. "We're optimistic they'll be cured."

For the Richmond family, the battle against leukemia began in June 2006, when Lauren was diagnosed.

She had had a necrotic sore that grew worse with antibiotic treatment. A test in the Children's emergency department revealed leukemia cells.

"It was quite a shock," her mother said.

Lauren began her treatment by spending a week in the hospital. She responded well and returned home, but was taken back to Children's by medical helicopter a month later, after she had a seizure at home.

An MRI scan found she had a blood clot in the front part of her brain, a rare side-effect of the chemotherapy.

"We were afraid she wouldn't make it," said her mother.

The family and her treatment team made the difficult decision to use blood-thinning medication to break up the clot, which could have caused bleeding in the brain.

But the treatment was successful and she rallied, sitting up in bed and eating a cheeseburger within a few days.

"I've been blessed with a strong faith that continually provides me with a sense of purpose," her mother wrote in her journal at the time. "For the last month and a half, I've looked for strength and purpose from my God when Lauren's pain and prognosis were beyond my control."

Lauren's cancer treatment was halted for a number of weeks as the blood clot resolved.

For Sydney, problems with the same type of cancer began a few months ago. In September, she had an intermittent fever and complained of pain in her arm. An X-ray of the arm was negative, but a blood test showed abnormal blood counts.

As doctors began to suspect leukemia, her mother remembered thinking, "This can't be happening."

Like her sister, Sydney quickly responded to initial treatment. And she, too, had complications.

She became so weak that she had to be carried everywhere for two months. Steroids made her face and body swell temporarily and gave her a ravenous appetite.

In November, she had a seizure and had to be rushed to the emergency room.

Soon after Sydney's cancer was diagnosed, her mother also lost her hair.

"Everybody's body reacts differently to stress," Mrs. Richmond said. "Mine just happened to do this."

Despite all her family has endured, she remains grateful for the expert, compassionate care her children have received. At Children's, the staff "goes to great measures to keep these kids comfortable and free from pain," she said.

She and her husband also are looking forward to spending the holidays with their daughters and extended family.

"It's going to be a wonderful Christmas, in spite of the heartache and the pain," Mrs. Richmond said.

"We're all very hopeful, and we'll celebrate Christ's birth and be together as a family. And that's the most important part of this holiday."