Life after stem cell transplant

Dr. Doug Taylor and Carol Richman
UC Davis Stem Cell Transplant Program director Carol Richman and pediatric oncologist Douglas Taylor oversee up to 60 transplants each year, achieving success rates that meet or exceed national averages.

Not long after David Rhodes underwent a stem cell transplant to treat his leukemia, the nurses at UC Davis Cancer Center gave him a nickname: Ironman.

Rhodes has no immediate plans to compete in a triathlon. Unlike most transplant patients, he is a senior citizen — and a grandpa. As recently as the mid-1990s, Rhodes, 72, would not have been a candidate for the procedure that saved his life. Advances in the use of lower-toxicity therapies changed that.

“People used to say you had to be an Olympic athlete to tolerate a transplant,” says Carol Richman, professor of hematology and oncology and director of the UC Davis Stem Cell Transplant Program. “Mr. Rhodes is a great example of how far things have come.”

Rhodes is one of more than 500 patients who have received stem cell transplants at UC Davis Cancer Center since 1993. Led by the widely respected Richman, the team includes specialists in all areas of transplant science and patient care. The program is the largest and most experienced of its kind in inland Northern California and the region’s only National Marrow Donor Transplant Program, giving patients access to potential donors worldwide.

Richman and pediatric oncologist Douglas Taylor oversee up to 60 transplants each year, achieving success rates that meet or exceed national averages. In May 2008, the program was accredited for the full range of adult and pediatric transplant services by the Foundation for the Accreditation of Cellular Therapy. This milestone gives UC Davis patients access to a wider range of national transplant clinical trials and increases the number of insurance companies covering the procedure.

Dr. Ted Wun"I honestly, truly have never seen another physician [Richman] more devoted to patients. She gives them her pager number and follows up with them while she’s on vacation or at medical meetings. It is extremely rare to find a physician like her nowadays."
—Ted Wun, UC Davis vice chief of hematology and oncology

Complex and intense, the field often leads to burnout for physicians, who shoulder a caseload of seriously ill patients requiring intensive follow up. Against that backdrop, Richman stands out, says Ted Wun, who performed UC Davis’ first stem cell transplant with her in 1993.

“I honestly, truly have never seen another physician more devoted to patients,” says Wun, vice chief of hematology and oncology at UC Davis. “She gives them her pager number and follows up with them while she’s on vacation or at medical meetings. It is extremely rare to find a physician like her nowadays.”

Richman came to UC Davis in 1992 from Chicago, where she had a reputation as a skilled and compassionate physician. Early in her career, she participated in some of the first stem cell transplants at Dana Farber Cancer Institute in Boston and has since been driven to perfect the process. When she arrived at UC Davis, she established the transplant program, eliminating the need for patients to travel long distances for the procedure. For Richman, watching patients recover and regain or even improve quality of life is tremendously rewarding. Over the course of the next few months, we’ll be sharing a few of their stories with you. Here is the first one.

Brandy Perkins and Ashely Wysocki
Brandy Perkins (left) with Ashley Wysocki

A benevolent stranger

It began with some shortness of breath and heart palpitations during a trip to San Francisco. Brandy Perkins, 28 at the time, attributed the symptoms to altitude, a reaction to her 6,000-foot descent from her home in South Lake Tahoe, Calif., to the sea-level city by the bay.

Doctors uncovered a different reason, and in December 2004 Perkins was diagnosed with myelodysplastic syndrome, a disease of the blood and bone marrow. A transplant was vital if Perkins was to survive. Like two-thirds of all transplant candidates, Perkins lacked a relative suitable to serve as a donor. That left her waiting, along with about 6,000 other patients, for an unrelated donor match to surface through the National Marrow Donor Program.

Eight candidates were tested and rejected. In April 2005, a match was found. Next came six days of chemotherapy treatment to destroy her malignant stem cells. Then it was transplant time, an experience that was far different than Perkins expected.

“I was envisioning a huge operation, but it was not like that at all,” Perkins recalled. “I watched TV and ate applesauce while it was happening.”

Through it all, one piece of information was kept secret. According to protocol, Perkins was not given the name or hometown of her donor: “All I knew was that she was female and 21.”

Perkins, moved by the knowledge that a stranger had voluntarily shared the cells that saved her life, wanted to know more. The rules, however, require a yearlong wait before any communication between donor and recipient.

At the year mark, after battling intestinal problems resulting from graft-versus-host disease, Perkins asked her UC Davis transplant coordinator to pass on her request to make contact. A long wait ensued, but finally a name, e-mail address and phone number arrived. Her donor was a college student in Long Beach, Calif., named Ashley Wysocki.

Synthesis coverSynthesis

Want to learn about the latest cancer programs and research at UC Davis? Read Synthesis, the cancer center's biannual magazine.

Contact Doreen Purvis for a free subscription to Synthesis.

Too nervous to pick up the phone, Perkins sent an e-mail, introducing herself and asking Wysocki if she’d be interested in a dialogue. The response — an enthusiastic “yes,” — came quickly, and the two women found they had “an amazing connection from day one,” Perkins says.

Their first face-to-face meeting came later that year. Perkins and her husband traveled to Southern California and met Wysocki at a steakhouse: “It was so emotional,” Perkins recalled. “I think we hugged for five minutes.”

“We sat and stared at each other a lot,” Wysocki says. “And for me it was almost awkward because I felt like I hadn’t done much of anything, but here I was up on this pedestal because I had saved her life.”

Since then, the friendship has blossomed and now includes their families. They are even planning a camping trip for both clans at Lake Arrowhead. For Perkins, meeting her donor and knowing that her transplant happened “because of someone else’s beautiful, selfless act has really changed the path of my life. I appreciate every day and realize that my relationships and quality of life are what are truly important.”

In upcoming features, read more about “ironman” and avid ballroom dancer David Rhodes, along with Curtis Richards, who has dedicated himself to helping children in his community through sports programs.