Allen Vollen and daughter Elana, before finding out he had Leukemia. A stem cell transplant will increase Vollen’s chances of surviving from 20 to 60 percent.Allen Vollen of Burlingame, Calif., was diagnosed in January with Acute Myelogenous Leukemia, a deadly cancer affecting cells of the blood and bone marrow and was told he had only a 20 percent chance of survival.
Finding out was the biggest shock he and his family had ever experienced. Doctors admitted a shaken Vollen, 63, to the cancer treatment center at nearby Stanford University Medical Center and began chemotherapy almost immediately.
“I thought about all the things I wouldn’t be a part of if I died – my family, seeing my grandkids,” Vollen said. “It was just so depressing.”
Vollen was told that the only way he could increase his chances of survival was a successful bone marrow transplant – a procedure that replaces cancer-infected bone marrow with healthy cells that will produce non-cancerous blood.
This would require finding a donor with blood that matched his exactly since the antigens, infection-fighting genes, on the donated marrow cells must be identical to the antigens on the cells of the recipient so that the donor’s immune system will engraft properly.
Usually, the best place to find “matching” blood is among family members. Unfortunately, no one of Vollen’s relatives had blood that matched.
At that point, doctors at Stanford began searching the National Marrow Donor Registry, a matching service set up by the U.S. government, for an outside donor. Unfortunately, the chances of finding a non-related compatible donor are 1 in 20,000 and the doctors were unable to find a suitable candidate in the United States.
As a last resort, they decided to look worldwide and turned to the Caitlin Raymond International Registry at the University of Massachusetts. Catlin Raymond is an independent registry with 50 databases from foreign countries.
After three months of searching, a donor match was found – in Israel.
Israel is home to three bone marrow donor registries. The largest, known as Ezer Mizion, was where Vollen found his miracle match. Ezer Mizion is a nonprofit Israeli health support organization in Jerusalem whose registry contains more than 130,000 names making it the largest Jewish donor registry in the world.
Finding a compatible donor in Israel was not a complete coincidence. Having a similar ethnic background between the bone marrow donor and the recipient makes it more likely that a match can be found. Vollen is Jewish, so it was more likely that the donor candidate would be another Jew.
“When I found out the donor was from Israel it was a confirmation of my Jewishness,” he said. “Now I feel connected to the Jewish people. We are not just another group of people.”
The medical procedure that will transfer the bone marrow from the donor in Israel to Vollen is a stem cell transplant, which will increase his chances of long-term survival to 60 percent. This procedure is still considered experimental and has been used to treat about 400 patients worldwide. The first stem cell transplant was performed at the Fred Hutchinson Cancer Research Center in Seattle and Stanford has performed over 100 such transplants during the last four years.
Stem cell transplants have improved dramatically since doctors began using the technique, due in large part to research in Israel at facilities such as the Weizmann Institute and the Hadassah Medical Center. The transplants are safer and have a better track record than traditional bone marrow transplants, which can have toxic side effects and are too dangerous for patients over 50.
In a stem cell transplant, the donor is given shots of Neupogen, a drug that increases the number of white cells and stem cells in the bone marrow that overflow into the bloodstream. The blood of the donor is then drawn through one arm, into a centrifuge-like machine that separates and collects the stem cells through a process known as apheresis. The blood is returned into the other arm of the donor soon afterwards.
Prior to Vollen’s procedure, the collected stem cells will be transferred to a courier in Israel who will fly to California to deliver them personally to Vollen’s doctors. The stem cells will then be injected into Vollen’s blood stream using a chest catheter.
If the procedure is successful, the new stem cells will mature into new bone marrow. The new, healthy marrow will replace the cancerous marrow that has been suppressed by the chemotherapy and begin producing cancer-free blood.
Vollen’s procedure was scheduled for mid-July, four months after his doctors began seeking a donor.
A week before the procedure, Vollen said he was looking forward to going ahead with it.
“I’m not really nervous,” he said. “I want to do this and do it well.”