Rare Transfusion Gives Child New Lease on Life
By Douglas J. Gillert
American Forces Press Service
SAN ANTONIO, Texas, Nov. 30, 1998 The sailor's kid is a "normal" 8-year-old these days, playing with friends back home in Portsmouth, Va. The strokes are gone, and so are the abnormal, sickle-shaped red blood cells that once clogged his vessels.
He owes his renewed health to the sure, steady hands of Army Dr. (Lt. Col.) Reginald Moore and a rare bone marrow transfusion he got at the Air Force's Wilford Hall Medical Center here in August. Moore, the staff pediatric hematology/oncology specialist, decided to perform the transfusion after the boy's sister proved a perfect match. Moore said the operation opens the door to more pediatric transplants when and where matches can be found.
"It's difficult to find a bone marrow match, so not a lot of children are going to be candidates for this surgery," Moore said. "There's only been about 200 performed nationwide, and this was the first done in San Antonio and in the military as a whole." But, he added, he has received calls from people interested in the procedure and would like to continue providing sickle-cell transfusions whenever possible.
He said he's confident the red blood cells from the sister's marrow totally replaced the boy's damaged cells. "We won't know for about a year if the sickle cells are totally gone, but that's what our goal is -- that he will no longer have sickle-cell anemia."
The ultimately fatal disease strikes one in every 500 black children; 8 percent of all black Americans have the sickle-cell trait. Of those who contract sickle-cell anemia, many reach maturity but succumb to the disease by their middle 40s. The highest death rate, however, occurs in the first five years, Moore said.
"Children are born with the disease, and it's best treated early," he said.
Moore's transplant patient remained hospitalized at Wilford Hall 39 days, about average for a bone marrow transplant patient. "He did remarkably well," Moore said. Now, he's back home and under the care of a hospital in Portsmouth, where he will receive regular checkups to see if his cells remain healthy.
New candidates for bone marrow transfusion include children who've had strokes, acute chest problems or other severe conditions, Moore said. The trick is to catch them before they become so ill they require blood transfusions, which can cause hepatitis. "If they have hepatitis, they aren't candidates for the transfusion," he said.
Once a child qualifies, the next step is finding a marrow donor. "There's only one chance in four you'll find a match in a family," Moore said. "If we can't find a relative, we'll then look for an unrelated donor, but that takes a lot more people."
Even if a match is found, Moore cautioned, transplants could be fatal. And the procedure is painful, if not fatal, for the donor.
Despite the difficulty in finding good, healthy matches and the risks involved in the operation, Moore and his fellow Air Force and Army hematology oncologists are eager to offer this new lease on life to other children.
"It's gratifying and very rewarding to see sick children smiling and healthy, again," he said.