Dr. Mona: Fighting For Life (aplastic anemia & stem cells)

CBS ^ | 04.13.06 | Mona Khanna, M.D., M.P.H.

[Coleus]

Imagine being diagnosed with a potentially fatal illness when you're just 26-years-old and a newlywed. But your one chance at survival is threatened because of a hurricane. That's what happened to a Dallas woman last year. Thui Diem Tran visits the hospital every month, but she doesn't mind. Doctors at UT Southwestern just saved her life. Tran is recovering from aplastic anemia, a potentially fatal condition. Less than a month after her wedding, Tran went from healthy, happy bride to a woman whose bone marrow had shut down…a woman who had just days to live unless doctors could find a way to save her. But Tran almost waited too long. When she started experiencing extreme fatigue right after her wedding, she just put it off to the stress of planning and anticipating the event. Then, when she broke out with a rash all over her hands and forearms, Tran ignored that, too. Finally, her exhaustion prompted her to see a doctor. That’s when she learned she had aplastic anemia. She was literally almost out of blood.

"It turned out my platelet count was so low it was almost non-existent," she says. The normal treatment for the condition is immunosuppressant drugs followed by a bone marrow transplant. Tran didn’t respond to immunosuppressive therapy. The bone marrow transplant was out because doctors couldn’t find a donor match. The matching problem was compounded because Tran is Asian-American, and donor rates among ethnic minorities are so low that finding a bone marrow match is almost impossible. That’s true for Asian and African-Americans, Hispanics, and other minority groups.

Tran's case was so severe her doctors feared they couldn't keep her alive long enough to treat her. “Her bone marrow simply wasn’t making any blood,” says Dr. Robert Collins, the UT physician who is treating Tran. "The only way we could treat her was a lot of blood transfusions and trying to prevent and treat infections…and she really was not in very good shape." Doctors turned to their last resort, a stem cell transplant. But the stem cells they planned to use were not the embryonic stem cells that have caused so much controversy, but rather, stem cells derived from something that’s regarded as medical waste; something that’s thrown in the trash thousands of times a day all across America just as soon as a healthy baby is born…the umbilical cord and the placenta. They contain a precious natural resource that the baby no longer needs, blood brimming with immature stem cells. When harvested and administered to patients like Tran who are suffering from blood disorders, these cells offer a life line of hope.

“In her case it was an easy decision (to use cord blood) because there were absolutely no other options,” Dr. Collins says. Cord blood is not only a rich source of stem cells; it has another great advantage. Dr. Collins explains. “The immune system from a cord blood unit is pretty immature so it doesn’t rev up and attack the patient, which can be one of the major problems of a stem cell transplant using cells from an adult donor.” A stem cell donation from an adult donor takes about two weeks to take hold and start producing new, healthy blood cells. But a stem cell donation from cord blood contains fewer cells, and it can take as long as six weeks before it kicks in. Tran’s doctors feared she didn’t have six weeks to spare, so they chose a dual cord blood transplant...using two donors to make sure she got enough cells to replace her bone marrow in time.

But before Tran could receive her transplant...Hurricane Rita threatened Dallas. Her donor cells had been carefully selected to give Tran the best chance of success. They were flown in from a great distance and couldn’t be easily replaced if they were lost in the hurricane. The impending threat sent the experts from Carter Blood Care in Bedford scrambling. They were processing the cells so they could be infused into Tran and wanted to make sure they stayed safe until the transplant. "I had a plan in place to actually move her cells out of Dallas if this roof were to be blown off so they would be protected,” says Sue Patchin, MT (ASCP), FBB, the department director for stem cell transplant for Carter Blood Care. Patchin is proud of the fact that Carter Blood Care is an accredited stem cell lab that works only with non-controversial sources of stem cells like cord blood and bone marrow. Fortunately, it turned out that Patchin’s precautions to protect Tran’s donor cells were not necessary.

Tran got her transplant...and they worked; they started making new, healthy blood and her prognosis is excellent. She’s regaining her strength and making plans to start a family once her treatment is complete. Now she and her husband are finally going to take their long-delayed honeymoon. “We’re going to celebrate our one-year anniversary in Las Vegas, try to take our chances out there,” she says with a laugh. Last December, President Bush signed a bill establishing a national cord blood program. A cord blood donation site will soon be established in Dallas.

[gaijin]

Tran is Asian-American, and donor rates among ethnic minorities are so low that finding a bone marrow match is almost impossible. That’s true for Asian and African-Americans, Hispanics, and other minority groups.

So..members of the nasty, white establishment are not only donating at higher rates, but at the HIGHEST RATES...?!