Transplant of stem cells gives woman a second life
Jessica Hahn was born in 1987, but in many ways she considers herself to be 8 years old. On February 14, 2001, she received a life-saving transplant of cord blood stem cells at Cardinal Glennon Children's Medical Center.
The transplant reversed the effects of bone cancer and leukemia. "I have two birthdays now," Hahn, of Imperial, told a group at the St. Louis Cord Blood Bank, a division of Cardinal Glennon Medical Center and the St. Louis University Department of Pediatrics.
Three months shy of turning 9 years old, doctors found osteosarcoma on Hahn's leg. Osteosarcoma is a bone cancer that attacks young people mostly ages 10 to 25. Fourteen months of chemotherapy killed 96 percent of the bone cancer, but it killed her ability to make new blood cells, a condition called myelodysplastic syndrome or "preleukemia." The cancer drugs caused hair loss and nausea. Her legs grew at different rates.
Four years of therapy made her a candidate for a cord blood stem cell transplant. Human stem cells can develop into any human tissue. Researchers see them as a fountainhead of cures for diseases. The major types are cord blood stem cells, found concentrated in human umbilical cords, and embryonic stem cells, from aborted or miscarried fetuses.
Hospitals in the region donate umbilical cords to the St. Louis Cord Blood Bank and Pediatric Research Institute. The staff at the Cord Blood Bank extracts the stem cells from the umbilical cords. The bank does not use embryonic stem cells. Each batch is tested for markers needed to match with a recipient, then stored in liquid nitrogen, said Dr. William V. Miller, medical director of the St. Louis Cord Blood Bank.
The St. Louis Cord Blood Bank has enough stored cells for 18,000 transplants, said Donna M. Regan, executive director. It has helped about 1,000 children and 500 adults. It sends vials of stem cells to 218 transplant centers in 36 states and 28 countries, she said. The cure rate of the use of cord blood stem cells is about 80 percent for children with leukemia, Regan said, and 65 percent for adults with other diseases. The most common uses are leukemia and immune system disorders, she said.
Two weeks before the transplant, doctors gave Hahn a megadose of chemotherapy drugs to kill any lingering cancer. As expected, "The chemicals ... oisoned her bone marrow, causing it to produce only a scant amount of blood," Miller said.
On Feb. 14, Valentine's Day, surrounded by her family, sealed behind the glass doors of "boy-in-a-bubble" clean room, she received an injection from a large syringe of cord blood stem cells. Shortly afterward, her skin inflamed like a sunburn and peeled. "Once I pulled skin from my foot, and there was enough that you could see my toes," Hahn laughed. "It was so gross." She had bad tastes in her mouth and other side effects.
One day, a severe pain in her leg was "good and bad news," Miller said. "It means her bones were growing again, but it's painful." About 75 days after the transplant, her white and red blood cells had come roaring back from her new bone marrow and immune system. "A hundred days after the transplant, I was normal," Hahn said. "Other children dreamed of (being something). All I wanted to be was normal, to be able to go hang out with other kids."
A NEW BIRTHDAY
The stem cells rebuilt her biology like a science fiction story. Her blood type changed from A to O negative. She lost her allergy to penicillin. "She has the DNA characteristics of the child whose parents gave the stem cells," said Drew Schumacher, outreach coordinator for the St. Louis Cord Blood Bank. "If we did a DNA test today, it would be different from what we got before the transplant."
This summer, she worked at the cord blood bank while on summer break from Rockhurst University in Kansas City. She's a junior majoring in biology and theology. She wants to research cord blood stem cells. Meanwhile, she speaks with children who face similar challenges.
"They seem to understand someone who's gone through what they're going through," Hahn said.