Eliza Martin wants her mom to come home from the hospital soon, happy and healthy. She wants to hear Andrea Brault’s booming laugh, now a whisper because of the chemotherapy for her leukemia.
Standing between that possibility for Brault and her family is a bone marrow transplant, which is one of the best treatment options for patients with acute myeloid leukemia. The transplant helps replace unhealthy blood-producing cells with healthy ones.
People can find matches for the therapy within their family or friends, or they can match with marrow donor registry programs. But for Black people, like Brault, and other people of color, matching with a donor through a service is harder in part because there aren’t as many donors of color, lowering the chances of finding the best genetic match.
Martin hoped a bone marrow donor registration drive could help improve her mom’s chances of finding a match. So in mid-March, Martin and her two sisters got about 40 people to show up at a fieldhouse in Farmington to get their cheeks swabbed and samples mailed off to a national registry.
When matching donors to patients, doctors are specifically looking for matches based on human leukocyte antigens, which are found on most cells in the human body. These antigens help the body identify its own cells, and foreign cells, which the immune system could then attack.
“We try to provide a perfect match if we can, meaning that the donor is matched at eight out of eight different locations in the gene to be a good donor for a person with leukemia,” said Dr. Alison Loren, director of the University of Pennsylvania’s bone marrow transplant program.
A perfect match, Loren said, means that the patient’s body is less likely to reject the transplant.
With fewer donors from people of African or Middle Eastern ancestry it’s harder for people like Brault to find perfect matches. Loren said about 80% of people who come from European ancestry can find a perfect match, but for people with African ancestry it’s about 30%.
While transplants can still be done with an imperfect match, there’s still a chance the patient’s body would reject the transplant.
“It can be a really difficult conversation to have with a patient who needs a transplant if we're not able to find a good match for them,” Loren said.
That’s why a bone marrow drive, like the one Martin and her sisters hosted, could help increase someone’s chances.
Donating bone marrow has a reputation for being painful, but Loren says there’s a relatively painless way for donors to do it.
“They have to take an injectable medication, usually for five days and then they go to a donor center that's near their home and they have an IV placed in each arm,” Loren said.
And Loren said people sit for a few hours, awake, connected to a machine that separates the blood into its elements of platelets, plasma, and white blood cells.
“Sitting for a few hours with an IV in your arm isn't usually particularly enjoyable, but it's not terrible, especially if you think that you're saving a life by doing this,” she said.
Martin said she’s close with her mom. The two of them got their associate’s degrees from Central Maine Community College and walked together at graduation.
Andrea found a match, through a donor registry, in late April, and now she’s preparing to receive the transplant.
But her family says the ups and downs of this process have been hard.
A routine lung biopsy and chemotherapy, which weakened her immune system, made talking nearly impossible. But now, as her recovery has improved, Brault is able to speak in a whisper.
Martin said the family is leaning on their faith to see their mom through.
“We really believe that God has his hand in this and work it all out for his greater good,” Martin said.
Martin said her mom has big dreams for what comes after the transplant and what she hopes is a return to full health: finishing her bachelor’s, eventually getting her master’s in social work and getting back to work as a substance use counselor.
Martin said her mother’s work speaks volumes to who she is as a person. She always wanted people she worked with to feel and know their full potential.
The focus for these next few weeks though is seeing Andrea through her transplant and getting her home to the people who call her the best mimi in the world.
