Bone marrow, cell collection to begin again

Kapiolani Medical Center for Women & Children will open a bone marrow and stem cell donor collection center on Oahu next month, restoring services lost when Hawaii Medical Center closed early this year.

The center will take in bone marrow and stem cells from donors who match patients with aggressive life-threatening cancers, such as leukemia, lymphoma and myeloma, who need a transplant within months, or sometimes weeks, to survive.

The center will support the Hawaii Bone Marrow Donor Registry, which lists 77,000 local residents willing to provide cells. The registry is the local branch of the National Marrow Donor Program, which has a database of more than 10 million.

"The registry is important because if you happen to be a minority, it’s one of your best chances (for a match)," said Randal Wada, medical director of Kapiolani’s bone marrow transplant program. "Its significance comes into play when the patients are not Caucasian. Given the racial diversity in Hawaii, this is extremely relevant for us because we’re in the best position to help ourselves."

For people to register as potential donors, their DNA must be collected through swabbing in the mouth, which is then used for tissue typing that is entered into a database used worldwide.

The local collection center comes into play once a match is found. In the past two decades, 338 Hawaii residents have donated bone marrow collected from the hip bone through a large needle, or blood stem cells extracted through intravenous catheters placed in the arm.

Hawaii Medical Center-East in Liliha previously collected donor stem cells and bone marrow. But since it closed in January, donors have had to travel to the mainland at a cost of about $25,000, which is billed to the transplant patient but doesn’t include lost wages, child care and other costs for the donor, Wada said.

"After HMC closed it meant that we had no way tocollect blood stem cells for our pediatric donors," Wada said. "Sometimes donors have issues with their jobs or families that would make traveling to the mainland forsomething like this a real hardship."

Kaimuki resident Renee Tulon­ghari, 39, flew twice to San Diego in February to donate bone marrow to a 39-year-old woman with aplastic anemia, a blood disorder in which bone marrow doesn’t produce enough new blood cells.

"If (the collection center) was in Hawaii, it would’ve made it easier on my family because I wouldn’t have to worry about child care and extra finances," she said. "We needed to front some money, too. There’s some people that don’t fly, and that could become an issue."

Hawaii’s poster child for bone marrow donations was 2-year-old Alana Dung, whose story drove 30,000 people across the state to be tested as possible donors. Dung died in 1997.

Fewer than 10 children in Hawaii and as many as 20 adults receive bone marrow transplants each year.

Since the first bone marrow replacement in 1978, more than 250 residents have received transplants, according to William Loui, Queen’s Medical Center’s chief of oncology and former medical director for HMC’s bone marrow transplant program.

Kapiolani recently received a $500,000 matching grant from the state to restore the bone marrow collection center in Hawaii, which also lays the foundation for the possible return of an adult bone marrow transplant program that closed along with HMC-East, forcing most cancer patients to travel to the mainland, Wada said.

Kapiolani now only does pediatric bone marrow transplants.

Chantal Napalapalai, now 26, was diagnosed with childhood leukemia when she was 15.

A year ago the disease relapsed, and HMC’s troubles nearly ended her chances of a bone marrow transplant. She contemplated her death.

"I was devastated. I was shocked and didn’t know what to expect," she said. "I wouldn’t have been able to (fly to the mainland). I wouldn’t have had a caregiver. If I went to the mainland, I would be inisolation for six months to a year."

But because she had been a pediatric cancer patient, Kapiolani made an exception for the Kapolei mother of two and did her transplant in May 2011.