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PEPPERELL — After a week of witnessing fevers, coughing and phantom bruises on her 2-year-old daughter, Ayva Rose Parsons, Malisa Mignosa knew something was wrong. That still didn’t prepare her for the diagnosis she got at Children’s Hospital in Boston.

“We walked into the emergency room, and we knew something was wrong, but we never expected cancer,” she said. “It was like a punch to the gut. I guess that was my first reaction.”

Ayva has acute lymphoblastic leukemia (ALL), the most common form of the disease in children. It attacks white blood cells, which help the body fight infections. If unchecked, it results in useless abnormal cells taking the place of healthy ones.

Mignosa, who lives in Pepperell and works in Ayer, said there’s a light at the end of the tunnel — ALL has the highest survival rate among leukemia strains, but only at the price of an intensive multi-year treatment plan.

They’re already familiar with the drill. Ayva was diagnosed on April 24 and has spent much of the following month getting transfusions and chemotherapy to clear her blood.

Mignosa was alongside her daughter for most of that treatment. While she described Children’s Hospital as the world’s best, she said the family was happy to come home May 21.

“It’s hard to live there,” she said. “We got to go home for two days, and it was probably the best two days we’ve had since getting the news.”

Even so, it’s hard to get away from the disease. Leukemia weakens the immune system and requires parents to be keyed into a child’s health. Right now, a slight fever means a return to the hospital for Ayva.

In-patient treatment for ALL typically takes about three months. The family returned to the hospital on May 23 hoping Ayva’s cancer was in remission and the next phase of chemotherapy could begin. However, that’s temporarily on hold because of an infection that figures to keep Ayva in the hospital for several more weeks.

Some 80 percent of ALL cases go into remission, Mignosa said, citing reasons for optimism. Past that, approximately 50 percent of cases stay in remission for more than seven years, which is considered “cured.”

Mignosa said she’s met a number of people at the hospital on both sides of that equation.

“A lot of kids go through the two years and then are fine, and then I’ve met a lot of people who have children who relapse and have to go through another treatment,” she said. “It’s something that keeps you always looking over your shoulder.”

Surrounded by friends and family, Mignosa said she’s meeting this life-altering circumstance with a positive outlook. She’s confident Ayva will recover and said her daughter is contributing to a clinical study that could help future generations avoid their experience.

“They said that, even compared to five years ago, they’ve come a long way,” she said. “Those are the little things you have to hold onto.”