Bone Marrow Volunteers Miss Match but May Yet Save a Life

When about 1,000 Orange County residents gave blood samples last fall in a search for a bone marrow donor for a Brea teen-ager suffering from leukemia, the chances were slim that a suitable match would be found.

Tests turned up no matches between those who offered to donate and 17-year-old Brandon Oba.

But those who volunteered weren’t wasting their time. Preliminary tests show that they may help save the lives of some of the estimated 9,000 other patients nationwide in need of similar transplants.

Their samples were entered into a national computer registry of patients with leukemia, lymphoma, Hodgkin’s disease or other blood disorders, and preliminary tests showed that three dozen of those offering to help Oba had tissue types that matched other patients.

“I think it’s likely that we’ll have virtually all saving a life within a couple of weeks,” said Dr. Rudolf L. Brutoco, Covina pediatrician and founder of the Life-Savers Foundation, which raises money for testing and helps recruit donors. “. . . We expect all 1,000 to save a life. It doesn’t have to be Brandon. It can be someone they never heard of before.”

This happened in Brandon’s case. He is scheduled to receive a bone marrow transplant in about a week from a donor in Minnesota. The donor, who was found through the registry, was confirmed in November as a match. Brandon will enter UCLA Medical Center on Monday.

Bone marrow transplants are one of the most successful treatments for victims of a chronic form of leukemia, which destroys the marrow cells in which blood cells grow and develop.

Marrow, a tissue found within the bones, manufactures blood cells and antibodies. Each individual’s bone marrow is a particular type, known as an HLA type, for human leukocyte antigens. There are thousands of different HLA types, which are determined by markers found on the surface of white blood cells.

Before the transplant, Brandon will undergo chemotherapy to kill cancer cells in his body, Brutoco said. At the same time, healthy cells also are killed, requiring the replenishment of the body’s bone marrow.

During the transplant, marrow tissue will be surgically extracted from a donor’s hip bone and transplanted into Brandon’s body. After the transplant, he will be isolated for several weeks because his body’s immune system will have been weakened, said Dr. Alfred Grovas, a UCLA Medical Center pediatric hematologist.

For Brandon and members of his family, the search for the donor and wait for the transplant has been grueling. But his father, Steve, said this was all they could do.

“I don’t know if there’s any choice,” Steve Oba said. The procedure was delayed until this month so Brandon could spend the holidays at home.

He said that his son, a senior at Brea-Olinda High School and a member of the wrestling team, was in good shape but was home from school because he was too distracted by the upcoming transplant.

“It’s a little hard to concentrate on your studies,” said Brandon’s mother, Karen Oba. “You just got to emotionally gear up.”

Grovas said Brandon’s spirits are high about the upcoming transplant.

“Brandon’s a pretty tough kid,” Grovas said. “I know he’s going into this fully aware of the risks and procedure. But I’m sure he’s going into this with a positive attitude.”

Brandon’s transplant from an unrelated person--reportedly the 275th such transplant since 1987--is still a relatively new procedure, Grovas said. The process is needed because only 40% of those who need transplants have relatives with the same tissue type, he said.

Brandon’s chances of full recovery are about 50%, he said.

Last fall, employees at St. Jude Hospital and Rehabilitation Center in Fullerton and Brea Community Hospital, along with area residents, turned out to give blood samples as part of an attempt to find a suitable donor for Brandon. The drive at Brea Community Hospital also was to seek donors for 17-year-old Anissa Ayala of Walnut. She still is trying to find a donor.

The drives were coordinated by Life-Savers, which helped pay the $75 cost of testing each potential donor. The test results were then sent to the registry, part of the National Marrow Donor Program based in St. Paul, Minn.

The program, which is funded by the National Institutes of Health in Bethesda, Md., has a catalogue of about 73,000 potential donors, said Pam Weinberg, a spokeswoman for the program.

Because the Marrow Donor Program doesn’t have the money to pay for recruiting and testing donors, Life-Savers has helped pick up a lot of the slack, Weinberg said.

“They have made a significant contribution,” she said.

Potential donors are typically 18 to 55 years old, in good health, with no history of AIDS, hepatitis or cancer other than simple skin cancers. Testing is simple, requiring only a blood sample.

But those who believe that they will match a particular patient might be holding false hopes. The odds of finding a suitable donor through such means are no higher than 1 in 20,000, McCurdui said. About 25 transplants due to matches made through the registry are now performed each month, said Pam Quam, another spokeswoman for the Marrow Donor Program.

Patients will resort to taking their case before the public even though their chance of success is slight.

“What choices do you have?” said Dr. Robert Gale of UCLA Medical Center. “It’s otherwise incurable. There is no other choice.”

There’s also the chance--as with the 36 Orange County residents--that potential donors from these drives will match other patients, even years from now. Those who rallied for Brandon were told that their test results would be placed in the registry, Brutoco said.

He was unsure when he would know if 36 potential donors who matched would pass further tests preparatory to a transplant because their identities are kept confidential.

Even though the drives didn’t find a donor for Brandon, Brutoco said, the important thing is that one was found in the end. Brutoco is very optimistic of his full recovery.

“He can be back in time for his high school graduation,” he said, “and be leukemia-free.”