Avalanna Routh, the little girl who captured the hearts of Justin Bieber and other stars, her doctors and many of those just lucky enough to meet her, has died at age 6.
Upon hearing of her death, Bieber tweeted Wednesday: "just got the worst news ever. one of the greatest spirits i have ever known is gone. please pray for her family and for her. RIP Avalanna. i love you."
"Our darling Avalanna went to Heaven this morning. Oh Avalanna, the brightest star -- you took our hearts with you, our greatest Love," her parents posted early Wednesday on a Twitter account started on the girl's behalf.
Avalanna nicknamed "Mrs. Bieber" by friends and family for her love of the pop star she eventually got to spend time with died of a rare and very aggressive cancer that during her short life failed to dim a bright and enduring spirit.
"She was one of the most vivacious, outgoing, engaging, precocious kids I've ever known," said Dr. Charles Roberts in an interview Wednesday with the Los Angeles Times.
Roberts, a pediatric oncologist at Dana-Farber/Children's Hospital Cancer Center, said those who knew Avalanna at the Boston center were devastated by her death: "People are taking it very hard. We knew it was coming, but it's extremely sad."
Just last year, staff at the cancer center threw Avalanna a wedding to Bieber. Knowing Avalanna to be a huge Bieber fan, they threw a party that included Avalanna in a red T-shirt that said "Future Mrs. Bieber," flowers, a wedding cake and a singer.
A Routh family friend created the Facebook page "Get Avalanna to Meet Justin Bieber," which resulted in Bieber meeting with Avalanna early this year in New York. Other meetings followed, and the pair became friends. Jessica Biel was another fan of Avalanna. She told the girl's story during a Stand Up to Cancer fundraising telecast earlier this month and later tweeted, "You're my hero."
Bieber, who performed Tuesday night on "Dancing With the Stars," was upbeat after first meeting Avalanna in February, tweeting: "that was one of the best things i have ever done. she was AWESOME! feeling really inspired now #MrsBieber."
Roberts said Avalanna had AT/RT, atypical teratoid/rhabdoid tumor, "a cancer that strikes babies and toddlers and arises in the brain .... We are still having an extremely difficult time curing this type of cancer." Most who are stricken with it die within a year, he said.
Avalanna was diagnosed at 9 months and lived to be 6, he said, thanks to aggressive treatment that included "extremely intensive chemo, directly into fluid surrounding the brain and tumor, combined with radiation therapy."
The 6-year-old, he said, epitomized the difficulties faced by young cancer patients and their families "chemotherapy, bone marrow transplant, more experimental chemo facing life-threatening disease at a time when most kids are just in school and worried about play dates."
What was special about Avalanna, he said, was how, despite difficult medical treatments, she remained optimistic, bubbly and delightful.
"She would just light up a room immediately," he said.
Avalanna's parents, Cameron and Aileen Routh, took up the fight against AT/RT and pediatric cancer in general, Roberts said. "They were tireless in raising awareness and raising funds."
But about two months ago, cancer-directed therapies were stopped for Avalanna. And Wednesday, friends and family were in mourning.
"Today it's absolutely devastating to lose what feels like a family member," Roberts said.
Rest in peace, Avalanna.