Isn’t every child supposed to have both an Abba and an Ima (father and mother)? Two year old Naomi and her baby brother almost didn’t. Now their mother stood there in tears of joy when she met Aryeh. “Because of you, my children have an Abba,” she cried over and over again.
At 61, Betzalel N. was just beginning grandfatherhood. He had three children and several tiny grandchildren. His drawer was filled with lollipops and his mind was filled with future plans: trips to the zoo with Grandpa, graduations, dancing at their weddings…until the day it all came crashing down. Leukemia. There would be no holding the hand of a grandchild as she gingerly feeds a baby goat at the zoo. Weddings would take place but there would be no glowing Zeidy (grandfather) to dance with the chassan (groom). It was over. He’d be gone. The doctors had tried everything and there was only one procedure left. A bone marrow transplant. If a genetically matching donor could be found somewhere in the world, he’d have a chance. If not, … Continue reading Two Grandpas: Their Sole Chance of Survival Was a Bone Marrow Transplant
Medical science has made great strides with illnesses that, not too long ago, afforded very little hope for the patient. In some cases, even the ‘man on the street’ has become part of the remedy. Bone marrow transplants are a case in point. Bone marrow transplants have become the cure for a wide variety of life-threatening diseases ranging from many types of cancer to immunodeficiency syndromes and anemias.
WHAT IS BONE MARROW?
Bone marrow is the soft tissue inside a bone which produces the body’s blood cells (red cells, white cells and platelets).
WHAT ARE STEM CELLS?
Stem cells are immature blood cells produced in the bone marrow. They can develop into red blood cells, white blood cells, and platelets.
HOW DOES A TRANSPLANT EFFECT A CURE?
A transplant donated by a healthy person can help patients with serious diseases live longer and healthier lives. If the bone marrow is damaged, the new cells produced will also be damaged. A replacement of undamaged cells will enable the body to produce healthy blood cells, thus creating the cure.
WHAT DISEASES HAVE BEEN FOUND TO BENEFIT FROM A BONE MARROW TRANSPLANT?
AML, ALL, CLL, CML, Juvenile myelomonocytic leukemia, Hodgkin lymphoma, non-Hodgkin lymphoma, severe aplastic anemia, Fanconi anemia, Paroxysmal nocturnal hemoglobinuria, Pure red cell aplasia, Amegakaryocytosis/congenital thrombocytopenia, SCID, Beta thalassemia major, Sickle Cell Disease, Krabbe disease, Hurler syndrome, MLD, ALD
EXACTLY WHAT IS TRANSPLANTED?
Three sources of cells used for transplants are:
Bone marrow (BM)
Stem cells from peripheral blood (PBSC)
Blood collected from the newborn’s umbilical cord after its birth (CB)
The doctor doing the transplant chooses the source most appropriate for the patient, taking into consideration the needs and preferences of the donor.
WHAT IS THE DIFFERENCE BETWEEN AUTOLOGOUS AND ALLOGENEIC STEM CELL TRANSPLANTS?
An autologous transplant involves only the patient’s own stem cells which are then transplanted back into the patient several days later after high doses of chemo and sometimes radiation. An allogeneic stem cell transplant is done using cells from another donor.
WHY CAN’T ANY KINDLY PERSON DONATE HIS MARROW?
Human leukocyte antigens (HLA) are proteins that are present in most body cells. These antigens help identify tissue types. The immune system utilizes HLA antigens in order to identify the cells that belong in the body and the cells that do not belong in the body. If the system recognizes cells very different from itself, it will reject them.
In one’s tissue-typing system, there are two groups of antigens. One group is inherited from the mother and the other group from the father.
HLA proteins are important in determining the compatibility of donors and patients for a stem cell transplant. In order to match tissue types for a transplant, the compatibility of ten of the donor and patient antigens are checked (generally, A, DR, C, B, and DQ).
When the transplant center, to which the blood samples were sent, examine the level of compatibility, they check the genetic similarity of the patient’s and the donor’s tissue types. Usually, a compatibility of at least 8 out of 10 antigens is necessary in order to approve a donor for a transplant.
WHY IS GENETICS A SUCH A MAJOR FACTOR?
Strict matching is necessary since the key to a successful replacement is genetics. If the donor matches the recipient, the transplant is not likely to be rejected and the chances of success are excellent. A sibling is a good choice.
WHAT IF THERE IS NO SIBLING AVAILABLE OR THE SIBLINGS’ DNA DO NOT MATCH?
A request is then sent by the oncology clinic to a universal registry which will search its database for a compatible potential donor. A match may be found among the patient’s neighbors or it may be a resident of a country across the ocean. The potential donor is usually thrilled to become a crucial part of a life-saving medical miracle.
ARE ALL REGISTRIES THE SAME?
If the patient is a member of a minority ethnic group and a Registry which focuses on that ethnic group exists, a request is sent to that Registry thus greatly increasing the chances of finding a match.
HOW DOES THE REGISTRY DETERMINE DNA?
The new registrant swabs the inside of his cheek with a Q-tip. The saliva is then analyzed for its genetic components. DNA testing is costly ($50 per test) which is why a registry must put a cap on the amount of registrants it can accept. When donations are made by the public, the increased funding enables the registry to grow, thus boosting the chances of a positive response to each search request.
WHAT IS THE DIFFERENCE BETWEEN A BONE MARROW TRANSPLANT AND A STEM CELL TRANSPLANT?
Both are the same as far as results are concerned. However, the method of harvesting the stem cells differs. Not that long ago, stem cells were obtained from bone marrow taken from the donor. This procedure was painful for the donor and often discouraged the donation. One cannot imagine the devastation by the patient and his family when a perfectly matching donor refuses to go ahead.
WHAT IS THE PROCESS OF STEM CELL DONATION? IS THERE PAIN INVOLVED IN STEM CELL DONATION?
In recent years, the cells are harvested from the donor’s blood. Medication is given to the donor beforehand to increase the stem cells in his circulatory system. Blood is then taken much the same as when donating a pint of blood. The stem cells are extracted from the blood which is then given back to the donor. The process continues for hours but the donor is kept comfortable during the whole procedure.
In some cases, minor discomfort such as muscle aches are felt but these soon disappear. The tremendous emotional satisfaction as he watches that little ‘bag of life’ taken to his soon-to-be blood brother will eradicate any lingering pains.
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In recent years, a bone marrow transplant has been proven to be the cure for a myriad of diseases. Many forms of cancer including leukemia andlymphoma in addition to other diseases such assickle cell anemia andSCID are only some of the life-threatening illnesses that have bowed to its power. Like penicillin, a bone marrow transplant can save lives. But unlike penicillin, it cannot simply be purchased at the local pharmacy.
Everyone dreams about it. Very few ever have the opportunity. I was one of those very few. True, I didn’t jump into the ocean and save a child from drowning or dash into a burning building to save a baby but I did save a life. A forty-year-old cancer patient had only one chance to survive—a bone marrow transplant. A genetic match is vital for success and I was that genetic match. An Ezer Mizion staff member asked me if I would do it. Would I do it???! How could I not do it?! How could I live the rest of my life knowing that because of a little discomfort, a little inconvenience, a young woman was prevented from living the rest of hers? Continue reading Saving a Life: The See-Saw Remains on Up
Last week, Racheli Klakner (39), a lawyer and arbitrator from Ganei Tikvah, received an unexpected envelope in the mail: An honorary medallion and letter of thanks from Ezer Mizion’s International Bone Marrow Donor Registry for her responding to the call to save a life with her bone marrow donation.
A few years ago, Racheli had gotten a phone call from Ezer Mizion’s registry informing her that she was found to be a good match for a bone marrow donation for a patient who needed her stem cells in order to survive and get better.
Klakner was thrilled by the phone call and felt that a huge privilege had fallen in her lap. Accompanied by her husband and son, she went to a meeting to hear about the options and the procedures. After reading articles and research studies, they decided to make the donation in the operating room under full anesthesia. Last week, she received an honorary medallion from Ezer Mizion for her efforts.
It is very important to Klakner to raise awareness about the importance of donating stem cells and saving lives. She wants to convey this message and tell her story, for the benefit of all the people who are afraid or are put off by the idea.
“If it will encourage others to donate, if they will come to understand the significance and the power of giving, if they will grasp what it is to save the life of another person, or if anyone who is uncertain about donating stem cells will be persuaded by my words to go ahead with it, then I will have succeeded in saving another life, and it is well worth it.”