Marrow donors provide precious chances

  • Published
  • By Micah Garbarino
  • Tinker Public Affairs
Chances? When you're an 11-year-old girl dying of acute myeloid leukemia, chances are like branches extended as you're being swept downstream in a torrent, or a foothold on a treacherous climb.

For many people, the best chance to live through leukemia comes in the form of a marrow transplant from a genetically matched donor. A small Department of Defense unit, based out of office and lab space in Rockville, Md., deals in these special chances.

With the help of a donor from the Department of Defense's C.W. Bill Young Marrow Donor Recruitment program, the young girl found a bone marrow donor.

The girl's donor, Brion Ockenfels, an environmental public affairs specialist from the 72nd Air Base Wing Public Affairs office, registered in the DOD Marrow Donor Recruitment Program in 1994, the same year his recipient was born. Years later, Mr. Ockenfels never expected the call to come that he was a match for patient thousands of miles away.

"As long as a person is willing to fight, why wouldn't I volunteer to help them do it? It cost me nothing and we are only in these bodies for a short time," Mr. Ockenfels said.

A match for donors can be rare, said Dr. Robert Hatzman of the Naval Medical Research Center and director of the DOD Marrow Donor Program. With more than 600,000 donors on file, 500 of those were matched with a patient and donated bone marrow last year.

This year, one of those people will be another member of Team Tinker. Maj. Craig Punches, commander of the 422nd Instrument Squadron, first registered for the program eight years ago. He is currently going through testing, evaluations and approvals before his scheduled donation date at the end of March.

Solid bone marrow matches are based on genetic typing found through the Human Leukocyte Antigen. There is a 30 percent chance that one of the patient's siblings is a suitable donor. Those chances are shrinking with the smaller sizes of American families, said Dr. Hartzman, a physician and retired Navy captain, who helped developed much of the genetic mapping used for marrow transplants.

The DOD program was founded in a 1990 initiative by Florida congressman C.W. Bill Young who knew a young woman who died waiting for a donor. Then, it was not possible to find a donor outside the family. What makes the military a good place for such a program?

First, everyone in DOD is willing to give of themselves -- a "fundamental volunteerism," Dr. Hartzman calls it. Second, the department is full of young, healthy people who are optimal donors and able to undergo the donation process.

Donor registration drives are conducted at military installations across the globe and even naval vessels at sea. Volunteers register by submitting their personal information and a cheek swab that provides their HLA type. Once the donor has registered, the DOD safeguards all their personal information, and only their HLA type, associated with an ID number, is shared with the National Marrow Donor Program.

When a patient has a need for a marrow transplant, and the match happens to come from within DOD, then Dr. Hartzman's organization acts as liaison between the national program and the military donor's command. When the command approves the donation, the member begins the physical evaluation - which Major Punches is currently doing.

Once the physical assessment is complete, donation can be done in one of two ways. The most common procedure takes 45 minutes to an hour. There is no risk involved, but it is uncomfortable, Dr. Hartzman said. After a general or epidural anesthesia, doctors go into to the pelvic bone through the hip to remove liquid marrow with a needle. This is how Maj. Punches expects to donate.

"Everyone reacts differently to the procedure, but most say that for a couple of weeks it feels like you fell on the ice," Dr. Hartzman said.

The second way is to give the donor a series of shots that increase the number of mature blood stem cells in the blood stream. The cells are then harvested in the same way that blood platelets are at a blood donation center.

"This is about as selfless a thing you can do, reaching out to someone you probably will never meet and giving them their best shot at life. A big thank you for all the donors and their commands," Dr. Hartzman said.

After Mr. Ockenfels' donation transplant, the 11-year-old shared four more years of life with her family and even helped conduct marrow recruitment drives in her community. She was happy to have had a chance, her mother tearfully told Mr. Ockenfels after her daughter's death at the age of 15.

Patient survival rates for a matched, unrelated donor transplant range from 20-90 percent based on a variety of factors.

"What if it was my child, my spouse, my parent? What would I give to have just one more minute with them?" Major Punches said.