Portland OHSU Employee First Unrelated Stem Cell Donor

09/13/02    Portland, Ore.

Kathy Jones has seen the worst of cancer. She's watched helplessly as young patients in her unit at Doernbecher Children's Hospital fought the disease with all they've got.

In July, she had the chance to get in on the fight and throw a few punches of her own -- she donated her own stem cells to a needy patient.

Kathy was the first person in Oregon to donate her stem cells to an unrelated recipient. Previously donors had to travel to Seattle to participate in the donation procedure. Advances in the National Marrow Donor Program's Red Cross program in Portland allowed Kathy to make her donation in her hometown in July.

The road to donation was not easy, it involved needles and pain and several hormone shots in the stomach, still Kathy insists, she should be the one "thanking" the patient who received her stem cells.

"How many chances do you get to save someone's life?" Kathy said.

The 47-year-old CNA has worked at OHSU for more than seven years, the last three on the oncology unit at Doernbecher. Throughout the ordeal, many of her patients were her inspiration.

Stem cells are any of the cells in the body that can grow into other kinds of cells. Blood stem cells are one of several types of stem cell. Healthy blood stem cells are vital because they replace our supply of red blood cells, white blood cells, and platelets. Red blood cells carry oxygen throughout the body, white blood cells fight infection, and platelets clot blood (control bleeding) when the skin or other tissue is cut.

When a person's blood stem cells become diseased or cancerous, it is a life-threatening situation. Often, the only hope for a cure is a blood stem cell transplant, which replaces the patient's diseased cells with healthy new cells. For the transplant to be a success, however, these cells must match the patient's own cells as closely as possible.

Marrow bloodstream is another source of stem cells, although not as rich a source as bone marrow. To have enough stem cells in a donor's bloodstream for a transplant, the donor is given a special drug called a "growth factor" (filgrastim is a drug that is commonly used for this purpose). When enough stem cells are present in the bloodstream, the donor undergoes a process called apheresis. During an apheresis session, the blood stem cells are separated from the donor's blood, and the remaining blood goes back into the donor's bloodstream through a sterile needle.

The first successful transplant using peripheral blood stem cells (PBSC) took place 1986. Some studies have shown that patients who have a PBSC transplant engraft (when stem cells start to grow and make blood cells) the donated cells faster than with other kinds of transplants, but there may also be an increased risk of chronic graft-versus-host disease (GVHD). GVHD occurs when the donated stem cells attack the patient's body.

PBSC donation and bone marrow donation have some differences. With PBSC donation there is no need for anesthesia, and infection is less likely to occur during the donation process. However, PBSC donation involves other risks that must be considered.

She had a central line put in her groin, received 12 growth factor shots and gave more than 38 vials of blood. All to give another human being the gift of life, her stem cells.

Because of the patient confidentiality, Kathy does not know much about the patient she helped. (Donor-patient confidentiality requires a one-year waiting period before donors and patients may learn each other's identity.) But she does know a patient with Hodgkin's lymphoma may be alive today thanks to Kathy's generous gift. When she finished her donation she had the opportunity to send him a card along with the stem cells -- a thank you card was what she had in mind.

"I should be thanking him for this opportunity" she said.

It was a gift that took a lot of dedication. Kathy spent hours of her lunchtime getting various tests and giving vials of blood before the actual donation day. In addition, five days before the donation she received 12 growth factor shots to stimulate her stem cell production. A painful experience that one of her patients, Justin Rappe, went through just days after she did.

"It was really cool for her to help someone she didn't know, " said 18-year-old Justin. He underwent an autologous stem cell transplant for acute lymphocytic leukemia. Kathy said his support really kept her going as the growth factor kicked in causing her bones and muscles to ache.

Other patient's families were by her side when she spent two days at Good Samaritan Hospital donating her stem cells. In all the experience took months, but the reward, she said would last a lifetime.

"Since donating I look at life totally different," said Kathy. She has already committed to donate her stem cells again if the recipient should need them.

Drew Ross, manager, American Red Cross Marrow Donor Services, adds that this newer method of collecting progenitor cells has given transplant center physicians another option to help patients that need bone marrow transplants. It also really gives donors an option also, besides the traditional way of collecting cells. Through this method we are able to collect more cells for the patient for the patient's transplant.

To learn how you can become a stem cell or bone marrow donor contact the American Red Cross at 800.922.3998 or visit the National Marrow Donor Program website at www.marrow.com

American Red Cross Pacific Northwest Regional Blood Services is the sole supplier of blood and blood products to over 80 hospitals in Oregon, Washington and Southeast Alaska. The region is the eighth largest of 36 American Red Cross blood regions and stretches throughout Southwest and Central Washington State and most of Oregon. In order to meet the needs of its patients, PNWRBS must collect at least 5,000 pints of blood each week. For more information visit http://www.pdxredx.org http://www.pdxredx.org/