Being separated by an ocean and having never met didn't stop Yvonne Vohl from offering a lifeline to Karen Castelblanco.
Castelblanco, 42, of Huntington Beach, was diagnosed with leukemia in 2010 and received a bone-marrow transplant from Vohl, 41, of Stuttgart, Germany, months after her diagnosis.
Three years later, the women who didn't know one another learned they now share a blood type — and some DNA.
"Before, I was A-positive, and now I'm B-positive," Castelblanco said about her changing blood type, as Vohl simultaneously finished the sentence. "And my [bone marrow] DNA is hers. So in the inside, we're the same."
Tears were shed as Castelblanco, along with her family and friends, gathered at Lake Park in downtown Huntington Beach on Saturday to visit with the woman who saved her life.
Delete Blood Cancer DKMS, a New York-based nonprofit that registers donors from around the world and transports bone marrow for transplants, helped organize the afternoon get-together and flew Vohl and her son out to California for a week.
"This is a celebration, not only to introduce Yvonne to everyone, but also to thank everybody here for everything that they've done," Castelblanco said.
Vohl said she wouldn't have organized such a large event to announce her arrival, but was humbled by the thanks she received from Castelblanco's family and friends.
"They told me that I'm a hero and that they wanted to bow down [to me]," Vohl said.
Monica Pavalko and Shelley Phillipps, friends of Castelblanco, said they've been by her side since Day One, helping her with chores and taking care of her family.
The two said her strong will and determination is what has kept her going for the past three years.
"She never complained or asked, 'Why me? This sucks,'" Phillipps said. "You felt like you couldn't cry in front of her. She always said, 'I'm going to beat this. I'm good.'"
On April 22, 2010, Castelblanco was diagnosed with acute myeloid leukemia, a form of cancer that lowered her blood cells and substantially lowered her immunity, said Dr. Vinod Pullarkat, her physician at USC Norris Cancer Hospital.
A month before her diagnosis, Castelblanco was participating in a half-marathon in Florida. She said she wasn't doing well in the run and thought she was tired or hadn't trained enough.
"We got home, and I just kept making excuses for why I wasn't feeling well," Castelblanco said. "I was saying I had the flu, or maybe I was pregnant, and all these things as to why I wasn't doing well."
She was admitted to Hoag Hospital in Newport Beach and underwent a round of chemotherapy, but the leukemia cells were not responding to the treatment, Pullarkat said.
Upon further inspection, Castelblanco was discovered to have an aggressive form of leukemia, and the only viable treatment would be a bone-marrow transplant.
With advancements in medicine and technology, 70% of patients with acute myeloid leukemia have a chance at surviving, Pullarkat said.
In Castelblanco's case, however, there was a slim success rate.
"She's lucky to be in that 30%," he said.
Castelblanco was transferred to City of Hope National Medical Center in Duarte, where Pullarkat was working at the time. The search for a bone marrow donor began immediately with Pullarkat trying to find matching tissue types.
Family members were tested, but no one was a match. So Pullarkat turned to the world registry to see if anyone could be a near-perfect donor for his patient.
Vohl was 25 years old when she registered herself as a bone marrow donor, she said.
The company she was working for put together a registry drive with DKMS, offering time off work and lunch to the employees who joined.
Years passed, and Vohl didn't receive a phone call from the company. Then, in August 2010, she was contacted and told she was a match for someone in the United States.
She said she didn't think twice about donating her bone marrow.
"My company gave me holidays," Vohl said. "DKMS booked the hotel and plane and organized everything."
The Stuttgart resident was flown to Dresden, where doctors checked her physical condition. Once she was cleared, she was given injections to increase her blood count for about five days and was hooked to a machine that would collect stem cells from her blood through an IV rather than from her hip, Vohl said.
"It was just two needles [in my arms] and a big machine behind me," she said. "It wasn't painful. It was like donating blood. It takes a little bit longer, but it was so easy."
Advances in extraction
The traditional way to harvest bone marrow was to sedate the donor and collect the cells from the hip, Pullarkat said.
But for the past 20 years, doctors have been extracting stem cells through the donor's blood.
"It made the donations much easier," Pullarkat said. "Bone marrow harvesting is still done, but the majority of the transplants nowadays are done by using blood stem cells. The end result is the same: They both go in the bone marrow, and they will produce new blood."
Those stem cells were then injected into Castelblanco so that her body could begin producing new blood, Pullarkat said. And since the cells are from Vohl, Castelblanco's blood type changed and her bone marrow DNA matches her donor's.
Receiving the transplant
Castelblanco received the bone-marrow transplant on Sept. 2, 2010, but she still wasn't in the clear.
"You get very sick for a while," she said. "The first 100 days, post-transplant is a very critical time. Once you get through that magical 100 days, then every month that you stay healthy, your chances [of surviving] become better."
She didn't stay in the hospital long after her transplant. Castelblanco said she was released 28 days after the procedure, which is better than most patients, but she still had to deal with the side effects of her transplant and medication.
Castelblanco developed a cataract in her right eye and experienced some intestinal issues and discoloration of her skin because of graft-versus-host disease (GVHD).
"It's just the new system attacking my body and trying to work on finding its new home," Castelblanco said. "A lot of my medication is to prevent attacks on my organs and things like that."
Pullarkat said Castelblanco's case of GVHD isn't life-threatening and is managed through medication. Because her leukemia is in remission, he considers the transplant a success.
Because of privacy and other issues, Castelblanco and Vohl had to wait for two years after the transplant to get each other's contact information.
"It's to protect the patient and the donor," Castelblanco said. "I could have had the transplant and still not have done well and maybe not lived. How could you not have a relationship with the person that saved your life? But if you don't do well, it could have a [negative] reflection on them."
Castelblanco's dream during those two years was to get ahold of Vohl as soon as she could to thank her. But as soon as she got her contact information in September 2012, Castelblanco didn't know what to say.
"'Thank you' just doesn't sound like enough," she said. "It so hard to type that emotion in an email, but I think we understood each other."
The journey ahead
Castelblanco said she is still under supervision and continuing to recover.
She had cataract surgery Aug. 12, and the color in her skin is slowly returning to normal.
Vohl said she's getting a tour around Southern California and will be visiting Disneyland and Hollywood.
And once she becomes healthier, Castelblanco said she's planning to go to Germany to visit Vohl in her home country.
"Life just goes on," Castelblanco said. "You just look at the positives every day, and if something were to reoccur, you just deal with it."