The Red Ceiling

This is the 30-month anniversary of my bone marrow transplant. BMTs have been around since the middle of the last century. They were originally conceived of as a way to resurrect cancer patients after administering “blisteringly” high doses of chemo.

The dose limit of a drug is set by its toxicity to normal cells. For most chemotherapy drugs, that dose limit rested principally on a single organ—the bone marrow. … The bone marrow represented the frontier of toxicity, an unbreakable barrier that limited the capacity to deliver obliterative chemotherapy—the “red ceiling” as some oncologists called it. – Dr. Siddhartha Mukherjee

Bone marrow transplants made it possible to give five-to-ten times the lethal dose of drugs. But rebooting patients with fresh marrow didn’t initially work. One trial with leukemia patients in the 1980s had an 88% fatality rate! And the 12 “survivors” didn’t last very long.

Transplants produce a host of complications, from graft-versus-host disease (GVHD) to secondary solid-tumor cancers, but outcomes have steadily improved over the decades. I’ve had a second cancer—squamous cell carcinoma—as a result of having my red ceiling reconstructed. The internal remodel hasn’t been pleasant but it’s given me two-and-a-half more years of life, for which I’m very thankful.

Legal Victory

As a founding member of (MMD), I’ve been part of a lawsuit to change the antiquated law governing morrow donations. On December 1, the Ninth Circuit Court ruled in our favor.They declared that bone marrow cells taken from the blood (apheresis) are not covered by the National Organ Transplant Act. NOTA rightly forbids remuneration for human organs but wrongly classifies bone marrow cells as such, whereas they are a renewable blood product.

Barring an appeal from the Attorney General, this decision clears the way for MMD to launch a pilot program to see if financial compensation might encourage more people to become donors.

If you’re not signed up yet, please consider joining the bone marrow registry. You can do so without leaving home. This selfless act could one day save a life.

For more information:

LA Times background article
Ninth Circuit Court Opinion

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