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A brother's gift saves sister's life

March 30, 2006|by JANET HEIM

GAPLAND - Seven-year-old Susannah Willems has always loved being around her big brother, Zach, but now their bond is stronger than ever.

Zach, 13, saved her life.

In a painful procedure last fall, doctors at Johns Hopkins Hospital in Baltimore extracted bone marrow from Zach to fight the deadly leukemia Susannah has been battling since 2001.

"Well, 'cause she's my sister," Zach said of what he did.

"I didn't think twice about it. It seemed like the normal thing to do."

Susannah was just 3 when she was diagnosed with acute lymphoblast lymphoma, a disease that strikes nearly 4,000 Americans, most of them children, every year.

It is the most common type of childhood leukemia, a cancer that begins in the body's bone marrow, the spongy tissue inside of the bone.

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The invasion triggers wildly-fast growth of cancerous cells, replacing the normal marrow where the body produces oxygen-carrying red blood cells, infection-fighting white blood cells and bleeding-controlling platelets.

Another Sept. 11 crisis



The diagnosis came on Sept. 11, 2001.

While the rest of the world was reeling from the news of the terrorist attacks on the World Trade Center and the Pentagon, Christina and Stewart Willems, of Gapland in southern Washington County, were receiving news of their daughter's own crisis at University of Maryland Hospital in Baltimore.

Susannah was very sick with a life-threatening illness, doctors told the couple.

"My world was what was going on in that bed," Christina Willems said. "I don't think I was affected by 9/11 like others."

It began with a cold



Normally healthy, Susannah had begun having colds and viral symptoms the month before. They came and went, but kept recurring.

Christina Willems took her daughter to their family doctor, who did a finger prick blood test and immediately sent the blood sample to University of Maryland Hospital in Baltimore. The result came back quickly: Acute lymphoblast lymphoma.

Susannah was very weak. The disease had left her with so few red blood cells that she was severely anemic.

Doctors gave her a blood transfusion.

And then began 2 1/2 years of chemotherapy, using drugs to kill cancer cells or weaken their ability to grow.

The treatments continued until early 2004, when doctors felt they had beaten the cancer into remission.

The family prayed for the best.

But as the months passed, Susannah began complaining of back pain while doing gymnastics.

Last May, doctors determined the bad news: Somehow, the leukemia had survived.

Facing a choice



This time, the Willemses had an option - three more years of chemotherapy.

Or, find a bone marrow donor.

Doctors told the family the latter would be best because Susannah's body had already received most of the anti-cancer drugs available, Christina Willems recalled.

She said a bone marrow transplant wasn't considered with the initial diagnosis because chemotherapy cures 80 percent of acute lymphoblast lymphoma patients.

So now, they had to find a donor.

Both Christina and Stewart, and their sons Zach and Elijah, now 10 and a fourth-grader at Pleasant Valley Elementary School, were tested to see whether their marrow would be a good match with Susannah's. Had that failed, next would have come a search of the National Marrow Donor Program Registry.

Doctors said Zach was an excellent genetic match. In fact, the best possible, Christina recalled.

Zach and Susannah are genetically identical, which is even better than if they were identical twins. Had they been twins, Zach would have carried the same harmful antibodies as Susannah, doctors told the Willemses.

The operation



Susannah had to endure three months of intense chemotherapy before the transplant to completely kill her bone marrow and immune system, as well as the leukemia.

And doctors did spinal taps, injecting needles into her spinal column to kill any leukemia that might have come back in the spinal fluid.

The transplant was performed Sept. 6, 2005.

Christina Willems had been home schooling her children until this school year. Zach, who had just begun seventh grade at Boonsboro Middle School, went to Johns Hopkins Hospital in Baltimore with his family.

The family arrived about 5 a.m. for Zach's outpatient procedure. While Susannah waited in her hospital room, doctors began the surgical procedure, removing one quart of Zach's bone marrow, a small fraction of what his body produces.

The marrow, which looks like thick, dark blood, was taken from the back of his pelvic bone with a special hollow surgical needle. The procedure usually requires four to eight incisions made in the pelvic area, incisions so small that they do not require stitches.

The entire process, which includes a general or regional anesthetic, usually lasts about four to five hours. The extraction of the marrow takes about 45 to 90 minutes.

There is little health risk to the donor, although soreness in the lower back and tiredness for several days following the procedure are typical.

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