by Richard J. Alley
Bernita Glass didn’t necessarily feel sick when she was diagnosed last year with an aggressive form of leukemia, saying, “I had a rash on my hand that was itching and I was retaining fluids.”
It wasn’t until her blood work revealed an extremely high white blood count that Glass, a Head Start director in Arkansas, received her cancer diagnosis. Her life would depend on a stem cell transplant. As with many transplant patients, finding an identical match remained crucial. For Glass, an African American, that obstacle was even greater due to the donor pool mix. Without a stem cell transplant, her prognosis was poor with survival estimated at only six months.
About the same time, Dr. Salil Goorha, medical director of Baptist Cancer Center’s Malignant Hematology and Transplant Program, attended a conference and learned about a new procedure known as haploidentical — or half-matched — transplant. Pioneered at Johns Hopkins and performed at only a few centers across the country, the procedure requires only a 50 percent match.
“We perform transplants to save lives, and we want to match the human leukocyte antigen (HLA),” Goorha says. “When we look at a match, genetics and ethnicity are key. Asians and African Americans are particularly vulnerable when finding a match because the donor population pool for those races is smaller.”
Haploidentical was originally used for sickle cell anemia patients, but now includes cancer patients. By transplanting stem cells, which live in donor bone marrow, new life is given to a sick immune system trying to fight disease. Researchers discovered when patients received cyclophosphamide, a chemotherapy drug, it not only kills the cells that cause graft-versus-host disease, but preserves the stem cells and the cells that destroy the cancer.
“In stem cell transplants, we first look for a hundred percent match,” says Goorha. “With haplo, we can rely on a 50 percent genetic similarity from a relative.”
When looking at donors, Glass found her 29-year-old son proved to be the best fit, even though all the siblings were tested. “We prefer younger donors who are stronger,” says Goorha.
Bernita became the first adult at Baptist Memphis to undergo a haploidentical transplant. Other than experiencing early complications, she recovered and her cancer has gone into remission. She has returned to work under close supervision by Goorha, who expresses equal gratification.
“I was led here for a purpose,” Goorha says. “And that purpose is to give great care.”
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