Jessie Quinn of Sacramento was 36 years old when loss of appetite, weight loss, some eye issues and finally pelvic pain sent her to the emergency room in 2010. Tests quickly revealed she had acute myeloid leukemia – a type of blood cancer that progresses quickly – and doctors told her that chemotherapy would probably not be enough; she would need a bone-marrow transplant.
Quinn, who has a science background, knew that finding a donor would be difficult. In college, she had donated to a bone-marrow registry after learning that people like her, with a mixed racial heritage, have a much harder time than others finding a match.
In fact, when she and her doctors scoured the registry for a match for her, only one name came up: her own.
“I didn’t know whether to laugh or cry,” Quinn said.
While searching unsuccessfully for a match for five months, Quinn underwent four cycles of chemotherapy to keep the leukemia at bay. What eventually saved her, though, was an experimental transplant using stem cells from the blood of a baby’s umbilical cord, an approach that can be used without perfectly matching blood types.
This therapy and another – haploidentical transplantation, which uses bone-marrow cells that are only half-matched to a patient – have revolutionized the treatment of blood cancers in the past few years. Every biological child is a half-match for a parent, and vice versa.
“Many patients who previously died for lack of a match are now cured of their underlying malignancy,” said Richard Jones, director of the bone-marrow transplant program at Johns Hopkins Kimmel Cancer Center.
Bone-marrow transplants, which infuse healthy blood cells taken from a donor, are used when chemotherapy and radiation fail to stop cancerous blood cells from taking over and ultimately destroying a person’s immune system.
In the past, a patient’s body would reject as a foreign intruder anything but a perfect or near-perfect match, a usually fatal development. Umbilical-cord stem cells, however, are sort of a blank slate because they haven’t been exposed to much life – such as bacteria and viruses – and thus are more easily accepted even if they aren’t a perfect match.
When Quinn’s doctor’s found no match on the donor registry, she turned to a clinical trial examining the safety of taking blood cells from umbilical cords, expanding their numbers in a laboratory and then infusing them into patients.
Because each umbilical cord produces only a tiny number of stem cells, umbilical-cord transplants take longer to work than standard transplants, which makes patients more likely to get fatal infections. And if cells from several umbilical cords are used, the chances of immunity problems increase.
This expanded cord-blood technique has been a “huge home run” for patients, said Colleen Delaney of the Fred Hutchinson Cancer Research Center in Seattle, who helped create it.
“No one had successfully taken stem cells and gotten them to grow and put back in a person,” she said. The advance should be particularly valuable for minorities and people of mixed-race background, whose chances of finding a matched donor were slim to none.
“This is where cord blood becomes an amazing and beautiful resource,” Delaney said. “We can find cord-blood donors for 99 percent of patients who cannot find a donor.”
Quinn was hospitalized for 30 days, and she said the recovery was difficult but relatively uneventful. Mostly she had to deal with overwhelming fatigue for the first year. She also developed graft-versus-host disease, which caused rashes when her skin was exposed to the sun. But she has been free of cancer for five years.
She remembers learning that she had leukemia and assuming that she would soon die.
“It still gives me pause – I went to Costa Rica – that I am able to travel and went backpacking and kayaking,” Quinn says. “I was so sure I would never get to do those things again. It’s an indescribable feeling.”
