be healthy - bone marrow transplant

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monthly health supplement focusing on health issues for African Americans

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  • Life was good for Jennifer Jones Austin, a 42-year-old lawyer and child advocate. She had a wonderful family a husband and two small children. She exercised daily, didnt smoke and enjoyed only an occasional glass of wine. There was no history of cancer in her immediate family.

    But on one day in 2009, she began to ex-perience cold-like symptoms. She thought she had the fl u. But her fever persisted and new symptoms emerged. Her vision began to blur.

    Her visit to her primary care physi-cian ended unexpectedly when she was transferred by ambulance to a local hospital. After a battery of tests her diagnosis was confi rmed. She had acute myeloid leukemia, a particularly aggressive cancer of the blood and bone marrow.

    Within a fi ve-day period, her life as she knew it came to a screeching halt. All was not immediately lost. The doctors bombarded her body with heavy doses of chemotherapy. It worked. The drugs drove her cancer into remission.

    But her doctors also knew that the vic-tory would be short lived. Without a bone marrow transplant, her doctors said that her leukemia was sure to return, and this time the results might be less favorable.

    Austin took the news well. I didnt have too much time to be fi lled with worry, she said. She admitted that she was concerned but not for herself. I was anxious for my

    children, she explained. I have to plan a life for them without me.

    Austin found herself outside her comfort zone of torts and depositions. Like most people, she didnt give blood much thought until she was diagnosed with a potentially fatal blood disorder. As if cramming for an exam, her knowledge of blood went quickly from the basics to advanced level. She learned that red blood cells carry oxygen and nutrients to every tissue in the body while white blood cells fend off infections and disease. And that platelets help the blood to clot.

    But as she discovered, more mysterious was the source of blood cells. Oddly enough, blood is formed in bone bone marrow to be exact. Bone marrow is the spongy tissue found in the interior of long bones, such as the thigh or pelvis.

    But theres another type of blood cell that became of particular concern to Austin, especially considering that they were the cause of her disease. Blood stem cells are immature cells that over time mature into one of the three blood cell types. Austins stem cells were defective and produced abnormal, or leukemia cells. Instead of preventing infec-tions and abnormal bleeding, Austins did the opposite. If left unchecked, those cells could have spread outside the blood and wreaked havoc on other parts of the body.

    When stem cells are destroyed by a dis-ease or treatment for a disease, they must be

    replaced by a procedure called bone marrow or stem cell transplantation. Simply put, stem cells are removed from a healthy person (donor) and infused into a recipient (host). If all goes well, the donor stem cells fi nd their way to the hosts marrow and start producing healthy blood cells.

    A simple enough solution, but not with-out drawbacks. The biggest battle is fi nding a suitable donor. Because of shared parentage, theres a 30 percent chance a sibling is an ac-

    ceptable match.More often than not, the donor is

    unrelated. Thats where the National Marrow Donor Program (NMDP) comes in. NMDPs Be The Match Registry is the largest and most racially and ethnically diverse registry of its kind in the world. The Registry has over 9 million donors and more than 185,000 umbilical cord blood units, and facilitates more than 5,200 transplants a year. About 70

    Jennifer Jones Austin (second from left), shown with her family, passed her fi rst year of recovery following a stem cell transplant for leukemia. Austin received an umbili-cal cord blood donation. (Photo courtesy of National Marrow Donor Program)

    BE Healthy

    Austin, continued to page 4

    VOL. 5 NO. 6 April 2011

    Sponsored by Boston Public Health Commission

    Better known as LJ, Lloyd Jones appears to be a typical 10-year-old kid. He wears his baseball cap backwards, prefers art to math and loves basketball.

    But LJ is not a typical kid. He has a rare blood disease that is almost impossible to pro-nounce but even more diffi cult to live with.

    In hypereosinophilic syndrome (HES) the body produces too many of a particular type of white blood cell, which can result in damage to the heart, lungs, liver and other organs. Not only is HES rare, it is basically unheard of in children, and is typically found in males over the age of 50.

    Finally knowing the diagnosis was a good fi rst step for LJs mother, Crystal Rob-inson, 47. At least she now knew why her child suffered repeated bouts of pneumonia. But knowing the diagnosis was only half the battle.

    The cure is an entirely different matter. Because of his chemotherapy treatments, LJs

    condition is relatively stable. But, according to Robinson, his doctors state that the only chance of a cure is a marrow transplant. His three siblings are not a match, so the familys

    only hope depends on a stranger. As the chief of the Stem Cell Trans-

    plantation Program at Dana-Farber Cancer Institute, Dr. Joseph H. Antin knows all too well about the life-saving procedure.

    Success of a marrow transplant depends on several factors. The age and condition of the recipient, the type and stage of disease and complications all have an impact. But match-

    ing how closely the donated cells match the cells being replaced is crucial.

    Proteins on the surface of cells warn the immune system of unrecognized intrud-ers. If the match is dissimilar, the immune system sets out to destroy the donated cells. That is why proteins of the donor are typed with proteins of the recipient to fi nd

    WAITING FOR A MATCH

    Ten-year-old LJ is waiting for a match to help treat a rare disease of the blood. (Photo courtesy of live.drjays.com)

    LJ, continued to page 4

    74% White

    10% Latino

    7% African American

    7% Asian

    1% Native American

    Percentage adult donors

    Source: National Marrow Donor Program

    A Call For HelpPeople of color are underrepresented in the Be The Match Registry, including cord blood donation.

    DO SOMETHING BIGNothing is bigger than saving a life. Shaquille ONeil, 4-Time NBA champion and spokespersonfor Be The Match Registry

    BONE MARROW TRANSPLANT: More African American donors needed

  • (NMDP), connects doctors worldwide to donors who are good genetic matches. Race and ethnicity matter here. A similar heri-tage produces a closer match, which is better for patients, accord-ing to the NMDP. Currently, African American, Hispanic, Latino, Asian and mixed background donors are in short supply. WHO CAN DONATE?

    People between 18 and 60 can register as donors. Some health problems are not a barrier: for example, well-controlled asthma, diabetes or high blood pressure; mild to moderate arthritis; and even early stage cancers of the skin, cervix, breast and bladder. Expectant parents can donate umbilical cord blood, which contains blood-forming cells used for some transplants.

    You cant be a donor if donation would be too risky due to your weight, or if youve had certain serious ailments, such as autoimmune disorders like multiple sclerosis or lupus; AIDS or HIV; hepatitis B or C; and most cancers and forms of heart dis-ease. Other health guidelines apply, too. Check with your doctor if you are considering donation and have questions.

    Registering to be a donor should not be taken lightly. If you are found to be a match that means a patient is depending on you to follow through with your commitment. The process is not

    Want to be a lifesaver?You neednt sprint toward the nearest burning build-

    ing or leap into raging waters. Instead, consider becom-ing a donor. Blood and blood products, and particularly bone marrow and organs are sorely needed by millions of children and adults dealing with life-threatening illnesses, blood loss or accidents.

    A great need exists for African American and other minority donors. Having a good genetic match raises the odds of success for bone marrow transplants and some-times even helps in blood transfusions.

    Read on to learn why becoming a donor is so impor-tant, who can donate, how its done, whether it affects your health and how to sign up. BONE MARROW DONATION

    Bone marrow transplants can be life-saving for people with serious illnesses, such as lymphoma and leukemia. Be The Match Registry, sponsored by the National Marrow Donor Program

    as simple as blood donation and it is important to be aware of what it entails before making the decision to register and be tested.HOW IS IT DONE?

    A cheek swab collects material for tissue typing. If you join the National Marrow Donor Programs Be The Match Registry, you will be provided with a cheek cell swab registration kit. You can also visit www.dana-farber.org/how/donatebone/calendar.html to fi nd a bone marrow drive near you. If you prove to be a match, the registry will contact you. Youll be asked to do tests for further matching, then possibly for a donation made in one of two ways: Non-surgically

    Stem cells and other key blood cells are collected from circulating blood. Peripheral blood stem cell (PBSC) donors take a drug called fi lgrastim for fi ve days. Then a sterile needle placed in one arm pumps blood through tubing to a machine that separates out the stem cells. The remaining blood is returned to the body through a needle in the other arm. Surgically

    Liquid marrow is removed from the pelvic bone through a hollow needle. Anesthesia is used so no pain is felt during the procedure.

    HOW WILL IT AFFECT YOU?Your body replaces the donated cells within four to six

    we

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