July 2012

Granulocyte Infusions Saved Little Katelyn

By Dr. Jennifer Andrews, Clinical Assistant Professor of Pathology (Transfusion Medicine) and Pediatrics (Hematology/Oncology)

When I first met Katelyn Do, she had already been diagnosed by my Pediatric Hematology colleagues with severe aplastic anemia. That means essentially that her bone marrow was no longer producing any blood cells, including white blood cells (in charge of fighting infections), red blood cells (in charge of carrying oxygen to all the organs in the body) and platelets (in charge of stopping any bleeding). Her doctors had started chemotherapy to help cure her of this disease, and those medications also decreased all of her blood counts. She was admitted to the hospital last fall for a very severe infection of her skin called an abscess. She was being treated with very strong antibiotics given by an IV but her infection was just not getting better. Her doctors consulted me in the Transfusion Medicine service at the hospital to start granulocyte (a type of white blood cell especially adept at fighting bacterial infections like abscesses) infusions to help her fight this infection. When physicians prescribe them, it means there really is no other treatment available. They are a ‘last ditch effort’ to fight off infection.

Thanks to Stanford Blood Center staff and donors, I was able to arrange granulocyte collection for the next day. Special thanks go to the regular platelet donors. The staff at Stanford Blood Center was easily able to call three donors in their platelet donor program that had blood types compatible with Katelyn, and they were able to donate precious granulocytes for her.

Katelyn received granulocyte infusions for three days (one infusion per day), and her infection rapidly improved. She was able to go home from the hospital, and now eight months after I met her, she is doing very well on only one oral chemotherapy medicine that she is able to take every day at home. Some children with severe aplastic disease don’t respond to chemotherapy at all and need a bone marrow transplant, but Katelyn has responded very well and will not need a transplant. She is a very active little girl, and has returned to her normal activities and ‘life as usual’ at home.

It’s because of the donors at Stanford Blood Center and treatment with chemotherapy by her doctors that Katelyn is still alive. Her infection was cured because of those granulocyte infusions. Also, during the course of her chemotherapy treatments, she has received both red blood cell and platelet transfusions to help her get better.

Blood donors, thank you so very much for donating life-saving products!

If you were a cell, which one would you be?

By Billie Rubin, Hemoglobin’s Catabolic Cousin, reporting from the labs of Stanford Blood Center

A heroic red blood cell - courageous, selfless, hard-working, picking up billions of oxygen molecules in the alveoli and coursing through the heart and every corner of the body electric feeding hungry tissues…

Or a quick bounding platelet - a cohesive force that brings everyone together to bond, hold hands across a gaping wound and save the waste of precious fluids and life itself…

Perhaps a mighty macrophage - a giant of a cell, a shape-shifter and relentless pursuer of evil, patrolling the body, taking care of its enemies and protecting all…

Or maybe a noble dendritic cell - the sentinel, the informer, the presenter of infectious evil to everyone in the immune world…

Perhaps you would be a stem cell - the creator, progenitor, mother, artistic source of all blood cells…

Which one would you be?

RBC Antigens - What Are They Good For?

By Billie Rubin, Hemoglobin’s Catabolic Cousin, reporting from the labs of Stanford Blood Center

Red blood cell (RBC) antigens have to be good for something - nature doesn't make useless things for no reason. We have similar ABO antigens to some on bacteria, pollen, grains, etc., and these may be involved in stimulating the production of our natural anti-A and anti-B antigens.

RBCs have another antigen system as well called "Duffy" (abbreviated as Fy); one of about 29 systems of antigens like the ABO system. The most common antigens in the Duffy system are Fya and Fyb. Most people have one or both and it’s quite rare to lack both.

Well, it seems that some malaria sub-types (Plasmodium vivax and Plasmodium knowlesi, for example) can get inside RBCs via these Fy antigens (like a hand-hold). There is a large percentage of people in Africa or of African descent, however, that are of the rare type that lack Fy antigens. If you don't have Fy antigens, you stand a better chance against these types of malaria and your descendants have an evolutionary edge on survival. Very interesting...

“Blood Donors Saved My Life”

By Michele Hyndman, Public Relations Manager, Stanford Blood Center

"It cannot be a coincidence that World Blood Donor Day is June 14. The same day my life was saved by donated blood. Amazing!"
-Melissa Price

On June 6, 2011, Melissa and her husband, Tim, and 3-year-old son, Flynn, welcomed twin boys, Keane and Hayes, into their family. Melissa's pregnancy and delivery had been normal. The twins were healthy and together weighed over 14 pounds which is considered big for twins. After a typical recovery period, Melissa went home to care for her family. "To me, my family was perfect and complete," she said.

However, eight days after the birth, Melissa began to hemorrhage at home while getting ready to take the twins to see their pediatrician. Melissa's mom drove her to Stanford Hospital. At her insistence, Tim took the twins to their appointment while Flynn played at the park with his nanny.

At Stanford, the bleeding was unstoppable. Melissa was rushed to the operating room. She woke up five hours later in agony and confused. "Turns out, things went from bad to worse to way worse in the operating room. My doctor performed an emergency surgery to save my life," said Melissa.

Melissa had lost two liters of blood. During the surgery, she was given four units of red blood cells and several units of additional blood products. The next day, her doctor ordered two more units of red blood cells at her bedside. It was transfused while she lay awake thinking about the people who had donated blood for her. "Because of blood donors, I am alive," she thought. "True, my doctor made life-saving decisions, but in the end what I needed to survive was blood. And thanks to complete strangers, my children have their mom."

Melissa works at Palo Alto Medical Foundation as a pediatric audiologist. Before her medical emergency, she remembers walking by red balloons and a sign announcing blood drives for Stanford Blood Center at least a dozen times. To her, it was just another blood drive. It was her husband and sister who were active blood donors. When Melissa sees those signs now, she has a new perspective on the importance of a plentiful blood supply.

At a recent Stanford Blood Center donor event, she had this emotional message for blood donors:

"Thank you, donors. Thank you for giving Flynn the opportunity to hold my hand on the way to his first day of preschool. And thank you for giving Hayes and Keane the opportunity to fall asleep to my lullabies. There are times when my mind goes back to that day and thinks 'What if it had gone the other way? What if I had not survived?' It is then that I look at my children and remind myself, 'It went this way.'

“On May 5, I celebrated another birthday and then a week later Mother's day. I had these days because of people like you. I am honored to be in your presence. I am in awe of your kindness, your selflessness. Don't ever forget what your gift means not only to the recipient, but also to their families. Thank you from the bottom of my heart. Thank you for my life."

The Gift

A Poem by Gil Gonzales, Stanford Blood Center Donor

The greatest of gifts that costs nothing to give
A gift of hope that offers a family a sense of relief
Just a little of your time, so that another may live
A minor inconvenience that spares others major grief
Offering the gift of life from one’s own veins
For even the poorest of us can give this priceless gift
When all seems lost a gift of a future, where hope reigns
Where those emotionally down, are given a spiritual lift
One’s donation of a little blood, is to another a gift of life
The precious fluid of one, can be another’s only chance
Offering a glimmer of hope where once despair was rife
Allowing someone a chance, for their healing to advance
Blood is like a river of life, that flows within us one and all
And while most of us have the ability to give, still so few do
Donors are often sought, sadly few care to answer the call
The apathy of so many is a fact of life, unfortunately sad but true
I am proud to be a donor, it’s not too much to endure
Two hours once a month is a gift I willingly share
For any donation is a gift of hope, but not a magic cure
It means so much to families to know that others care
The feeling I get, knowing my gift meant so much to a family
A warmth derived from having helped save the life of another
Even though I’ll never know who, that’s fine with me
Hopefully a family will be blessed with a loved one’s recovery
To return a loved one to a family, is a feeling beyond compare
Be it a child or an adult, no greater feeling can one derive
For when we give blood, it is life itself that we share
What nobler cause can there be, but to help keep another alive

The veins in our bodies, like the veins in a mine
Can be harvested to save lives one drop at a time