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Finding the right match

Posted By Sharon Kanon On March 28, 2004 @ 10:00 pm In | No Comments

25,000 people showed up last week at sixty testing centers in Israel to find a match for nine year old Matthew, an American who developed acute leukemia at age 5. A courier from the Dana Farber Medical Center in Boston, Mass., recently flew to Israel to pick up a precious little package. Taking the next flight back to Boston, he delivered the parcel to doctors at the medical center. They immediately scheduled a bone marrow transplant for a 45-year old leukemia patient whose life depended on the unique cells in the package.

Weeks later, the man is now recovering from the operation. And he can thank Ezer Mizion, an Israeli non profit organization that runs the Bone Marrow Donor Registry, the world’s largest source for stem cells.

“We were very excited that we were able to find a match for the man in Boston,” said Ofra Konikoff, the Registry coordinator. “Every day we get calls from transplant centers from all over the world to see if we have a matching donor. Transplant centers in the U.S., Australia, South Africa, and elsewhere like our efficient, quick response time.”

Established five years ago the Registry has data on more than 150,000 potential donors, and has already facilitated 80 lifesaving bone marrow transplants. It has found a match for another Dana Farber patient, who will receive stem cells from an Israeli donor next month – bringing the number of successful matches up to 81.

One-third to one-half of a plastic bag used for blood donation (a little more than a sandwich bag) of stem cells can create new, healthy breathing cells that can save the lives of children and adults suffering from more than 100 different diseases. Stem cell transplants are used for most types of cancer, for neurological therapies, and may even be used for heart disease in the near future.

Finding cells that will match genetically with a patient is almost as hard as finding a needle in a haystack. Family members are usually the first source. Unfortunately, less than 30% of needy patients manage to locate a related donor within their immediate family circle. The rest – 70% – must find a matching unrelated donor. The odds – only about 1 in 30,000 – are against finding a matching non-related bone marrow donor.

“The chances for a match increase significantly if the patient and potential donor share the same ethnic background,” said Konikoff. Israel, with its diverse ethnic population, coming from 60 different countries, offers an extremely advantagous pool of potential donors.

Another big advantage of potential donors in Israel is that they can be tracked down quickly, since the country is relatively small, whereas, in the US, people frequently move from state to state.

Dr. Bracha Zisser, Director of the Registry, recalls that she once convinced an army officer to give a short leave to a soldier in an elite unite, so that he could donate bone marrow. “He said ‘No!’ the first time I asked. Desperately, I called again, and asked how he would feel if he had a little girl whose life depended on the transplant. He answered ‘Yes.’”

Zisser – who has a PhD in Nursing – is the driving force behind the Bone Marrow Registry. She initiated the world-wide registry at the request of parents of 15-year-old leukemia victim Moshe Schayek who had already collected 3000 samples, without finding a match. “We did another drive which brought in 2500 potential donors, but again no match. Moshe passed away.”

“Our goal is to get 500,000 potential donors, in order to provide for the vast majority of Jewish patients throughout the world who need transplants,” said Zisser, who has a personal connection to the task. She and her husband, Motty, just celebrated ten years since he received a successful transplant. According to Zisser, one out of every ten cancer patient needs a transplant.

Last week, 25,000 people showed up last at the sixty testing centers they had set up around Israel for a special Bone Marrow Drive. set up to find a match for two children – 8 year old, Noam Otlongi, an Israeli who is suffering from leukemia, and nine year old Matthew, an American who developed acute leukemia at age 5.
Drive organizers reported that the reaction they received to the call for donors far exceeded their original expectations.

“We were thrilled by the fact that we exceeded our expectations for this national drive by more than 10,000 people. In many centers we were forced to close early out of fear that we didn’t have sufficient funds outlaid to process the blood samples for the numbers who showed up,” said Zisser.

The Israeli Army also agreed to Ezer Mizion’s proposal to tissue-type every new recruit and include the young men and women in the Registry. “We provide the army with DNA for each recruit. The Registry gains the addition of young potential donors who can be tapped for many years to come,” said Zisser. Since tissue analysis is so expensive, Zisser says that she prefers donors between the ages of 18 and 40.

Ezer Mizion has run bone marrow drives in the U.S. – among the Syrian community in Los Angeles, and in Deal, New Jersey, – which have been very successful. Raising funds to pay for the costs of laboratory analysis of the samples is even more important. One high school student in Deal organized a basketball tournament with sponsors and entrance fees for both players and spectators.

Blood samples are sent to the University of California for analysis and storage. (They are fast and charge the least.) “Initial analysis of the HLA tissue of each donor costs $40. But most serious donor registries also do the next stage (at a cost of $20) to get an important indicator of matching,” said Zisser.

In a 10-day dramatic countdown from when a donor is found – he or she can still opt out until this point – the donor’s suitability is rechecked, and his willingness to proceed is confirmed. The green light is given to the transplant center to prepare the patient.

“We use a modern, painless method for stem cell collection,” said Zisser. Four or five days before, the donor is given a stimulant to encourage new stem cells to go out of the marrow and into the bloodstream. Stem cells are collected from the blood sample taken from the right arm, and the blood is then returned to the left arm.

According to Konikoff, the donor doesn’t know who is receiving his or her stem cells.

“After a year, if the donor and the recipient both ask to know, then they are put in touch with each other,” said Ofra Konikoff.

The meeting is usually very emotional. A 23-year-old young woman from England and her 32-year-old Israeli donor have developed a warm friendship. “I am thrilled that my stem cells were a life-saver for Anne,” said Miriam.

Contributions to the Ezer Mizion Bone Marrow Registry may be sent to: the US office, Ezer Mizion Bone Marrow Registry, 1302 50th Street Brooklyn, NY 11219; in Israel: Oranit/Bone Marrow Registry, 40 Kaplan Street, Petach Tikvah, 49210, Israel


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