This Issue

Bone marrow transplant:
More African American donors needed

Waiting for a match

It takes a little part of you to
make a person whole

Giving blood

Looking to donate?

Q & A

A closer look


When bone marrow is unhealthy


Bone marrow (stem cell) transplants are often recommended for conditions that result in the production of abnormal blood cells, such as the following:

Cancer

• Acute lymphocytic
leukemia

• Chronic lymphocytic leukemia

• Acute myelogenous leukemia
• Chronic myelogenous leukemia

• Hodgkin’s lymphoma

• Non-Hodgkins lymphoma

• Multiple myeloma

Others

• Sickle cell disease

• Thalassemia
• Aplastic anemia

• Severe immune deficiency disorders

When bone marrow is unhealthy

A call for help

A lifeline

The umbilical cord is the baby’s lifeline, but once clamped and cut after the baby is born, it can be the lifeline for someone else. Cord blood — once considered medical waste — is rich in stem cells, which can be used in transplants. But time is limited. You have to complete enrollment to donate cord blood by the end of the 32nd or 34th week of pregnancy depending on the blood bank used.

• Call the Be The Match Registry at 800-507-5427 to find out which hospitals in your state participate.

In Massachusetts, Brigham and Women’s Hospital and University of Massachusetts Memorial Medical Center take part.

• If your hospital is not listed you can still donate. Contact the Carolinas Cord Blood Bank at 919-668-2071 or Lifeforce Cryobanks at 800-869-8608

There is no cost to you and no harm to you or the baby.
If you don’t donate, the blood is thrown away.
A closer look


Image courtesy of National Marrow Donor Program

More than 70 percent of the time peripheral blood stem cells, which circulate in the bloodstream, are requested for donation. The process is very much like blood donation. Blood is taken from one arm and transferred to a machine which separates and retains the stem cells. The rest of the blood is returned to you in the other arm.

Generally, donors are required to take a medication for five days prior to the donation to boost the stem cell population in the blood. The process itself takes about four hours and is often done for two days.

A lifeline

Dana-Farber/ Harvard Cancer Center 2011 National Minority Cancer Awareness

DANA-FARBER/HARVARD CANCER CENTER
Initiative to Eliminate Cancer Disparities
2011 National Minority Cancer Awareness


April 17 - April 23

Boston Public Library Cancer
Awareness Display


• Codman Square Branch Library
690 Washington Street

• Mattapan Branch Library
1350 Blue Hill Avenue

• Brighton Branch Library
40 Academy Hill Road

April 28: 12 - 1 p.m.

Secondhand Smoke Exposure
Harvard Street Neighborhood
Health Center
632 Blue Hill Avenue


May 16: 11 a.m. - 1 p.m.
Skin Cancer Prevention
Roxbury YMCA
285 Martin Luther King Boulevard


April 21:
9 a.m. – 4 p.m.

Reducing Cancer Disparities & Promoting Health Equity Among Socioeconomically Disadvantaged Populations
Beth Israel Deaconess Medical Center
Riesman Lecture Hall, 330 Brookline Avenue

Registration is required: http://sesrcdbostonapril2011.eventbrite.com

All events are open to the public
For any additional information contact
Athene Wilson Glover at 617-632-4860

Another good reason to visit the dentist


“All you have to do is open your mouth.”

— The Head and Neck Cancer Alliance


The oral cancer examination is painless and quick … and life-saving. When cancers of the head and neck are found early, the cure rate is high. Annual screenings by a doctor or dentist should be a part of your regular physical or dental checkup. The provider:

• Inspects your face, neck, lips and mouth.

• Feels the area under your jaw and the sides of your neck, checking for unusual lumps.

• Asks you to stick out your tongue to check for swelling, color and texture.

• Using gauze, lifts your tongue and pulls it from one side, then the other.

• Checks the roof and floor of your mouth and the back of your throat.

• Feels and examines the insides of your lips and cheeks for red or white patches.

• Places one finger on the floor of your mouth and, with the other hand under your chin, presses down to check for unusual lumps or sensitivity.

Source: National Institute of Dental and Craniofacial Research

Oral, Head and Neck Cancer
Awareness Week is May 8 – 14.


Photo by Vannessa Carrington/Mass. Eye and Ear

Get screened for head and neck
cancer. It’s free, quick and painless.

Boston Medical Center
Moakley Building Lobby
830 Harrison Avenue
Date: April 2
Time: 8 a.m. - noon
617-638-8260

Tufts Medical Center
860 Washington Street
Date: May 12
Time: 2:30 – 4:30 p.m.
617-636-1664
Mass Eye and Ear
243 Charles Street
Date: May 13
Time: TBA
617-573-3340
Dedham Family Dental
Dr. Helaine Smith
30 Milton Street, Dedham
Date: May 11
Time: 9 a.m. – 1 p.m.
781-326-4600

Mass General Hospital
Voice Center

One Bowdoin Square,
11th Floor
Date: May 13
Time: 9 a.m. – 1 p.m.
617-726-0218
Remember to call ahead to confirm
time and date
of screenings.

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A call for help

People of color are underrepresented in the Be The Match registry, including cord blood donation.



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)
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 pronounce but even more difficult 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 first step for LJ’s mother, Crystal Robinson, 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, LJ’s 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 family’s only hope depends on a stranger.

As the chief of the Stem Cell Transplantation 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 matching — how closely the donated cells match the cells being replaced — is crucial.

Proteins on the surface of cells warn the immune system of unrecognized intruders. 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 find the most suitable match.

Most recipients receive stem cell donation from complete strangers taken from a pool of donors worldwide. But this pool is lacking in donors from people of color. Race in itself does not matter. “We are pretty much the same,” said Antin. “It’s more how proteins are distributed.”

Some groups of people are more insular with little influx of outsiders making them very similar. But some people — often people of color — have a lot of mixing, which makes matching more difficult. “There’s a little bit of this, a little bit of that,” he said. “You can’t put a light bulb from a Toyota into a Honda. It’s still a light bulb, but the wiring is different.”


Joseph H. Antin, M.D.
Chief, Stem Cell Transplantation Program
Dana-Farber Cancer Institute

A successful transplantation can cure the disease and stem cells are the key. “They provide for the next generation of cells,” said Antin. “It’s like planting seeds to re-establish normal function.”

And that would be a great relief to LJ. He seems to take his condition in stride. To avoid the prevalence of germs in most school settings, LJ is home-schooled as suggested by his doctors. He does go outside but often under the protection of a mask. His mother says that he is somewhat of a prisoner in his own house.

LJ admits there are some things that are hard to take. Being in the hospital is one of them. And the illness and medication sometimes make him break out in a rash and cause an occasional headache. Even worse, LJ complained, “I can’t skateboard.”

LJ has become a celebrity of sorts. His mother’s never-ending search for a donor has brought his dilemma into the media limelight. The two have pleaded his case on television, radio and at countless donor drives. So far, no match has been found.

There have been many advances in transplantation techniques over the year. One major improvement has been the introduction of reduced intensity transplantations that has allowed the inclusion of previously exempt candidates.

At one time the age limit for a transplant was 35 years old, according to Antin. Because some of the diseases of the blood occur in older people, “We were not treating the bulk of people,” he said.

With reduced intensity chemotherapy and radiation, older people can now take part. “People in their early seventies are now being treated,” he said.

Even those with reduced organ function are now potential candidates. High dosage chemotherapy — used in preparation for stem cell transplantation — was not advised for such patients.

A few words from Dr. Antin

Courtesy of Dana-Farber Cancer Institute, Stem Cell Transplantation Program

But all too often that excluded those suffering from debilitating blood disorders such as sickle cell anemia, a disease that predominantly strikes blacks and can result in serious organ damage. As a result of reduced intensity transplants, the door is now open to a possible cure for those with sickle cell disease.

There are three methods to donate stem cells. They can be harvested from the marrow of bone or extracted from the bloodstream.

A newer option is umbilical cord blood donation, which poses no threat to the mother or baby. If not donated, it is thrown away. Cord blood is a good option for people of color. “It’s a clean slate,” said Antin. The cord blood has no functional immunity, which allows hematologists to take some liberties. “The match can be less perfect, but not damage the host,” he said.

For her part, Robinson stresses the need for donors of color and cautions people to not believe the myths about donation. “Just do a little research,” she advised. She admits she gets a little frustrated. “If you can take the time to get a tattoo or a body piercing, you can take the time to do this,” she said. “And it is less painful.”

LJ is quick to chime in. “It’s not hard to register,” he said. “Waiting [for a donor] is hard.”