A link between donors, volunteers, staff & friends of the Stanford Blood Center WINTER 2007

CALENDARHave Your Gifts Wrapped

While You Donate!Hillview Center onlyAll Saturdays Thanksgiving through Christmas DayBring in your gifts and we’ll wrap while you donate!Let someone else worry about taping and scissors fora while, you’ve got an important job to do; savinglives.

HealingHeARTs T-shirts!All CentersMonday, Dec. 17through Saturday, Jan. 12Our annual collectibleshirt is back; designed byanother talented patientfrom Lucile PackardChildren’s Hospital. Wear one home when youdonate on one of the dates above.

Daily Holiday Prize Drawings!All CentersMonday, Dec. 17 through Saturday, Jan. 12Local vendors have donated fabulous gifts to giveaway each day for 22 days! One winner will be chosen each day amongst all who donated in theCenters.

Win a Specialized Hardrock XC Bike!All CentersFriday, Dec. 21Enter to win and you may ride off with this great setof wheels, courtesy of our friends at Menlo Velo.

AMC Movie Tickets to Each Donor!All CentersMonday, Dec. 24 through Saturday, Jan. 5Donate during the holidays and be rewarded with aticket for AMC theatres. It’s our thank you for coming in to donate when we need you most!

Enter to Win a $25 Valero Gas Card!All CentersMonday, Dec. 31 through Saturday, Jan. 5You might win a chance to gas up and go! Threedonors each day, one at each Center, will win aValero gas card good for $25 during this promotion.

Casino Night Community Mixer!Hillview Center3373 Hillview Avenue in Palo AltoWednesday, Jan. 2, 4:30 – 7:30 p.m.The money may be fake, but the lives you’ll save arereal! Donate during this annual donor favorite and getsome buffet grub, Rat Pack tunes, and blackjack fun.

Pint for a Pint!All CentersMonday, Jan. 7 through Saturday, Jan. 12Get a coupon for a free pint of Baskin Robbins icecream when you donate on these dates.

LifeLink

TOP PHOTO:Jessamine is a lively eight-year-old who loves her little brother, Chase. She is also fighting neuroblastoma, the most common extracranial solid tumor. Treatment will consist of chemotherapy to shrink the tumor, surgery to remove it, radiation to make sure there is norecurrence, and a stem cell transplant to replenish Jessamine’s white blood cells. So far,Jessamine has received two transfusions of red blood cells.

Milestones+

Stanford Blood Center was createdin 1978 to meet the increasinglylarge and complex transfusionneeds of Stanford Hospital andLucile Salter Packard Children’sHospital at Stanford, and to per-form research and teaching. Weare proud to uphold a standard ofservice excellence in meeting theneeds of physicians, our generousdonors, and our diverse patientpopulations.

If you have any suggestions forupcoming issues of LifeLink,please contact Brooke Krannichat krannich@stanford.edu, or650-723-8270.

Special thanks to our contributors: Michelle Bussenius,Monica Doleshel-Aguirre, Lori Kunder, Jennifer Reczowski,Julie Ruel.

We would like to thank the fol-lowing for their continued contri-butions to our Centers:

Andronico's, Los AltosBetter Bagels, Mountain ViewHobee's, Palo AltoJJ&F, Palo AltoNoah's Bagels, Palo AltoSigona's, Stanford Shopping CenterStanford Floral Design, Palo Alto

Holiday Hours Our three centers will be closed for holidays on Tuesday, December 25, and Tuesday,January 1. On the dates listed below, we will operate on a slightly different schedulethan usual. For a complete list of our regular center hours, please visitbloodcenter.stanford.edu/bcinfo/hours.html.

Congratulations to all who recently reached a mile-stone donation. Your dedication is appreciated by theinnumerable patients whose lives you have touched.100 Donations

Frankie JemisonVince YalonJames LevisonDavid G. OlsonSusan SorensenMary Sue GrasshofDennis L. FeickGail Ann WaldoGerhard HahneErnest BoydLawrence YeggeGaelen Harber200 Donations

Graham Burnette

300 DonationsDave Ahn

500 DonationsDick Tagg

TOP PHOTO:Milestone Donor Sue Sorensenand her husband Ted.

BOTTOM PHOTO:From left: Milestone Donor andSBC Volunteer Bob Laughead,Milestone Donor and BMTCoordinator Diane Hill, SBCVolunteer Coordinator TessaMoore, SBC Public RelationsManager Michele Hyndman, andLiz Laughead.

Saturday, December 22All centers open as usual, but with specialhours for platelet donations as follows:

Hillview Center: 7 a.m. – 3 p.m.Campus Center: 7 a.m. – 3 p.m.Mountain View Center: 7:30 a.m. – 3 p.m.

Monday, December 24Hillview Center: 7:30 a.m. – 3 p.m.Campus Center: 7:30 a.m. – 3 p.m.Mountain View Center: 7:30 a.m. – 3 p.m.

Wednesday, December 26All centers open as usual, but with specialhours for platelet donations as follows:

Campus Center: 7 a.m. – 6 p.m.

Saturday, December 29All centers open as usual, but with specialhours for platelet donations as follows:

Hillview Center: 7 a.m. – 3 p.m.Campus Center: 7 a.m. – 3 p.m.Mountain View Center: 7:30 a.m. – 3 p.m.

Monday, December 31Hillview Center: 7:30 a.m. – 3 p.m.Campus Center: 7:30 a.m. – 3 p.m.Mountain View Center: 7:30 a.m. – 3 p.m.

Special hours for platelet donations for allthree centers: 7 a.m. – 1 p.m.

The Science ofblood

IN THE SUMMER 2007 LIFELINK, the Science ofBlood article “Increasing the Odds” examinedStanford Blood Center’s Histocompatibility,Immunogenetics, and Disease ProfilingLaboratory’s (HLA) important research in develop-ing tests that assist organ transplant matching.

Although transplant acceptance rates haveincreased greatly since the first organ transplants

were performed decadesago, many people who needtransplants are, for variousreasons, unable to receiveone, or experience rejectionafter transplant. Researchers,including ones here at SBC,are continuously seekingnew tests, treatments, andtechnologies that will allowmore people (in the U.S.

alone, there are an estimated 74,000 patientsawaiting a kidney transplant) to find a match, andbe successfully transplanted.

SBC’s HLA Laboratory Director, Dr. Dolly Tyan,has dedicated her life’s work to discovering waysto save lives through improving transplant match-ing tests and protocols. Dr. Tyan’s connection withSBC spans several decades, beginning in the early‘70s when, shortly after receiving her master’sdegree in Biological Sciences, she joined SBC as a

Research Assistant. Tyan, under the direction ofDr. Carl Grumet, studied serology (in general, thestudy of the antibody content in blood serum) andtrained alongside the late Dr. Rose Payne—anoted expert in tissue typing, and pioneer in trans-plant matching research.

After leaving SBC, Tyan moved to SouthernCalifornia, received her PhD in Microbiology andImmunology, and became Director of the Cedars-Sinai Medical Center Transplantation andImmunogenetics Laboratory and a professor at theDavid Geffen School of Medicine at UCLA. Onefocus of her research involved discovering ways toovercome barriers in finding matches for patientswith high levels of antibodies.

As mentioned in Part I of Increasing the Odds,the best organ matches occur when the donor tis-sue and recipient are as compatible as possible,and cross-match studies are negative, meaning thatthe organ recipient does not have antibodies thatmay react with HLA (human leukocyte antigens)present in the donor organ. A positive cross-matchindicates that the patient has developed anti-HLAantibodies to those present in the organ tissue, andalmost assures that a transplant will fail.

Finding an organ match is difficult enough, andunfortunately, for patients who are highly HLAsensitized to many different HLA types—meaningthat they have high levels of pre-formed anti-HLAantibodies—finding a match is next to impossible.Moreover, if such patients are transplanted, theysuffer very high rates of allograft loss (organ rejec-tion).

And the number of patients awaiting transplantwho are highly HLA sensitized is growing. In2003, an estimated 32% of patients awaiting akidney transplant had HLA antibodies. To respondto this population, Dr. Tyan has sought ways todecrease patients’ HLA sensitivity enough to allowtransplant to occur. Tyan, and other researchers,discovered that IVIG therapy, (Intravenousimmunoglobulin) effectively provides this windowof opportunity to allow HLA sensitized patients toreceive a kidney. IVIG products are derived fromhuman plasma and have been used for decades totreat primary immunodeficiency disorders.

During clinical trials, a high-dose IVIG product,designed to desensitize the organ recipient toHLA, is administered to selected patients prior to

HAT WE ARE LEARNING

OW HAS THE POTENTIAL

CHANGE ORGAN-

TCHING POLICY.

—Dolly Tyan

Increasing the Odds—Part II: R E S P O N D I N G T O H L

TOP PHOTO: Dolly Tyan

LEFT PHOTO: Zhongmin Su, Lily Bulanadi, and Julie Engstrom working in the Histocompatability lab.

designed to desensitize the organ recipient to HLA, is adminis-tered to selected patients prior to transplant. Before IVIG treat-ment is considered, tests are first performed that determine thepatient’s antibody specificity. Once specificity is determined, acytotoxicity assay is performed. This test involves reacting IVIGwith the donor’s antibodies to see if cell death occurs. If theIVIG appears successful in inhibiting cell death, the patientreceives a number of IVIG doses, and hopefully, will becomedesensitized to HLA and able to receive a transplant.

IVIG therapy has enabled transplantation of patients previ-ously considered untransplantable, and, in concert with newdiagnostic techniques, has resulted in many positive outcomes.Dr. Tyan believes that improved organ testing platforms, IVIG,and other pre-and-post transplant therapies have the potentialto dramatically increase the number of patients eligible fortransplant, and provide better matching between donor organand patient.

Dr. Tyan asserts, “What we are learning now has the potentialto change organ-matching policy.” Dr. Tyan returned to Stanfordas Director of the HLA Laboratory in 2006 and brings to SBC not

only her many years of experience, but a new mission. She andother researchers are working to encourage The United Networkfor Organ Sharing (UNOS) to adopt more emerging tests andtreatments into their organ matching protocol. UNOS is thenational organization that is responsible for the entire organmatching and allocation process and data collection for everytransplant occurring in the United States. Currently, UNOS reliesupon cross-matching, an arguably outdated technique, to deter-mine organ donor and recipient matches.

Dr. Tyan believes that a policy change in how UNOS deter-mines matches can save lives. Increasingly, clinical trials andstudies are demonstrating the efficacy of new organ matchingtests and pre-operative treatments, and changes in organmatching policy are sure to become reality in the near future.Despite her significant contributions, Dr. Tyan is modest abouther accomplishments, and describes her life’s work as gratify-ing “when what you know how to do really helps.” And here atSBC, we’re grateful to Dr. Tyan and researchers worldwide fortheir tremendous efforts in discovering ways to improve andextend lives.

other.” And they’ve been busy; since 1987, Stanford hasdone more than 3,400 transplants.

One of those recipients is Michael Wu. In January,2003, he was diagnosed with Chronic MyelogenousLeukemia (CML) after complaining to his doctor aboutpersistent abdominal pain. He and his then-girlfriend,Jennifer, were shocked to hear that he had leukemia andneeded immediate treatment, especially since they werejust starting their lives together and had so much to lookforward to—they had recently bought a fixer-uppertogether and were planning to be married the very nextweek. Together, they postponed the wedding and re-aligned their focus on getting Mike well. He began takinga laundry list of prescribed medications that compromisedhis immune system; he lost about 30 pounds.

Some of the drug therapies Mike underwent eventu-ally made him feel better and stronger, and he spentsome time at home, returned to his job as an engineer,remodeled their kitchen, and he and Jennifer were mar-ried on May 14, 2003.

After being ultimately disappointed with the resultsof drug therapy which did not help to control his CML,Mike was relieved to hear from Stanford Blood Centerthat a suitable marrow donor had been found in Chinathrough the NMDP Registry. He underwent a bonemarrow transplant in July, 2004, and several transfu-

sions of platelets and red blood cells in the followingweeks of recovery. And, while there were some painfulside effects—sores, a staph infection, a urinary tractinfection, fingernails falling off—of radiation andchemotherapy, Mike says “I feel very, very fortunate.Despite having some issues arise during and after thetransplant, I survived it! All the many doctors, nursesand hospital staff at Stanford Hospital are trulyremarkable. They saved my life. I even got my BMTdoctor—Robert Negrin—to bike with me after I recov-ered.” One person Mike hopes to eventually thank inperson is his anonymous bone marrow donor.

Having leukemia has changed Mike’s focus in life.“I decided not to go back to my previous job after mytreatment. Being so close to death made me realize howimportant time is, so now I spend it doing things Ienjoy and doing things that matter: spending time withloved ones, cycling and staying healthy, and raisingawareness and funding for blood-related cancers.”Mike and Jennifer are actively involved with Team-in-Training, The Leukemia and Lymphoma Society, andthe Asian American Donor Program to support otherpeople who are battling cancer.

SOURCES: MARROW.ORG, BMT.STANFORD.EDU, LEUKEMIA-LYMPHOMA.ORG, AADP.ORG

Bone Marrow Transplant ProgramCONTINUED FROM OUTSIDE RIGHT PANEL

R E S P O N D I N G T O H L A - S E N S I T I Z E D PAT I E N T S

Bone Marrow Transplant ProgramH A S I T S 2 0 - Y E A R A N N I V E R S A R Y

TO UNDERSTAND HOW GREAT THE NEED for marrowdonors is, it helps to know a little about the NationalMarrow Donor Program (NMDP). For a successfultransplant, the tissue type of a donor needs to matchthe patient’s as closely as possible. The NMDP main-tains a registry of people all over the world who arepotential marrow donors; currently, that list is morethan 12 million people strong. When a patient needs atransplant and a donor is not available within the fami-ly, the NMDP registry is searched to find registereddonors who match the patient’s tissue type. Potentialdonors are then contacted, and if they choose to partic-ipate, they then begin the process of final selection.Besides the NMDP, other crucial parts to this processare a Donor Center and a Transplant Center.

In 1987, Stanford Blood Center became the fourthentry on the NMDP’s list of Donor Centers. The firstcouple of years were quiet. “Back then, there were nomatched donors selected from Stanford Blood Center(SBC). We finally got established and averaged four orfive donors per year,” says Derek Leith, Bone MarrowDonor Coordinator. “In fact, our first donor traveled toPalo Alto and stayed with Diane, who was DonorCoordinator at the time,” he says as he looks at hispredecessor, Diane Hill, with admiration and pride.Diane continues, “Well, the donor asked me abouthotels in the area, and we had spent so much time talk-ing that I felt like we were old friends. So I wasn’tgoing to let her stay by herself in some sterile hotelroom,” she says. “I picked her up at the airport,cooked dinner, and then drove her to the hospital thenext morning for her donation. People who are willingto undergo a medical procedure in order to help astranger deserve all the warmth and hospitality in theworld.” It is with that level of personal commitmentthat Stanford has grown into a much larger program.They currently usher about 14 people through thedonation process each year.

The Transplant Center of our BMT program ishoused at Stanford Cancer Center and StanfordHospital. The integrated team includes researchers, cli-nicians, administrative staff and a lab for processingblood products. “Teamwork is a core value of ours anda big part of our success,” says professor RobertNegrin, MD, director of the BMT program. A greatasset of the program is its team of experienced nurses,

some of who havebeen with the pro-gram from the begin-ning and who workclosely with the doc-tors.

Kate Tierney, RN,PhD, has been a clin-ical nurse with theBMT program for 18years. She recognizessupportive care as one ofthe most drastic changesduring her tenure: “Inthe 1980s, anti-nauseamedications were notaround, and the lengthof stay for recipients was25-30 days. Now, wekeep patients for about15 days after their trans-plant, and are able tomake their recovery more comfortable by administeringdrugs that keep them from feeling nauseous.” LauraAdams, Administrative Director of the BMT program,explains that there are three types of BMTs:“Allogeneic donations are when a matched donor isfound—from either a family member or the NMDP;autologous donations are when a patient has their owncells collected, frozen and then re-administered whenneeded; syngeneic donations are rare—it’s when oneidentical twin gives cells to the other.” And they’ve

TOP PHOTO:Derek Leith and Diane Hill are trulydedicated to their work at the BMTDonor Center.

BOTTOM PHOTO:Mike Wu and his wife, Jennifer, celebrate their third visit to the annualBone Marrow Transplant Reunion withMike’s BMT doctor, Robert Negrin (center).

CONTINUED ON INSIDE RIGHT PANEL

Patients with leukemia, lymphoma and other life-threatening diseases can be treatedby a bone marrow/stem cell transplant. Stem cells are derived from marrow, andwhen transfused, they help reinitiate the patient’s immune system.

MOUNTAIN VIEWDONOR CENTER

515 SOUTH DRIVE, SUITE 20

MOUNTAIN VIEW, CA 94040

CAMPUS DONOR CENTER780 WELCH ROAD, SUITE 100

PALO ALTO, CA 94304

HILLVIEW DONOR CENTER3373 HILLVIEW AVENUE

PALO ALTO, CA 94304

S T A N F O R D B L O O D C E N T E R L O C A T I O N S

3373 Hillview AvenuePalo Alto, CA 94304-1204http://bloodcenter.stanford.edu

NONPROFIT ORG.US POSTAGE

PAIDPALO ALTO, CAPERMIT NO. 28

Ongoing Promotions—Free “Thinking of You” Cards for Friends and FamilyAll Centers, CanteensYou will now find Thinking of You cards in our canteensfor your use. These are lovely note cards to send to apatient or someone else who may need a lift knowingyou’ve done a good deed with them in mind.

Monday Movie Madness PLUS! Now at Campus for ABC!Hillview & Campus Centers Mondays 7:30 a.m. to Noon at Hillview7 a.m. to 10:30 a.m. at Campus

We need your help on Monday mornings. Donate at 3373 Hillview Avenue in Palo Alto anytime between 7:30 a.m. and Noon and you will receive an AMC theatres envelope with movie ticket and vouchers for asmall popcorn and a small fountain drink. Receive thesame gift pack when you give blood through an appointment for ABC donation at our Campus location,780 Welch Road, on Monday mornings. Let StanfordBlood Center take you to the movies!

How To Reach UsAppointment Office

650-723-7831 or 888-723-7831

Administration650-723-7994

Autologous and Designated Donations650-723-6667

National Marrow Donor Program650-723-5532

Web Sitehttp://bloodcenter.stanford.edu

E-mailgiveblood@med.stanford.edu