Hemapheresis Center Drives To Save Lives


Mike Field
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Staff Writer


     When Nancy Roth got sick, she feared the holidays.

     A 1989 diagnosis of stage III non-Hodgkins lymphoma meant
her only hope for survival was to undergo massive, near-lethal
radiation treatments and chemotherapy. So powerful were the drugs
employed against the cancer that her body would lose its ability
to produce the blood cells and platelets necessary for life.

     In order to survive the treatment, she would have to have an
autologous bone marrow transplant in which her own bone marrow is
harvested, treated with a drug, frozen and returned after the
most intensive phase of the chemotherapy was completed. During
the course of the ordeal--and for some time thereafter as her
body slowly recovered--Roth would need frequent transfusions of
blood components, including, often, daily supplies of platelets,
the cells that enable blood to clot. 

     But platelets are in perennially short supply, especially
around the holidays. "It was scary to think my well-being hinged
on someone's willingness to donate platelets during the
holidays," said Roth, who has been cancer-free for more than five
years now. "Platelets only last a few days, so I was told there
might come some time when they simply wouldn't be available,
because to get them, someone has to go down and sit for two hours
on the machine."

     "The machine" Roth refers to is a sophisticated piece of
medical equipment that draws blood from a donor's arm, separates
blood cells, saves the platelets and returns the remaining
components to the donor through the other arm. A centrifuge
spinning at 1600 rpms within the device performs the actual
separation; donors spend 100 minutes attached to the machine,
generally time enough to process six or seven pints of blood.

     The Hopkins Hemapheresis Center has a baker's dozen machines
ready to collect platelets at its headquarters on the eighth
floor of the East Baltimore campus's 550 Building. The problem is
finding donors enough to keep the machines busy.

     "Currently among the university and the hospital we have
about 190 employees who donate," said Pat Brodsky, donor
development coordinator for the Hemapheresis Center. She
considers the participation rate relatively low, but speaks
optimistically of doubling the number of employee donors in the
next year or so. 

     "Generally people become donors when someone they know
develops cancer and needs platelet transfusions," she said. "Most
people aren't even aware that there is a need, or that platelet
donation exists." To encourage new donors, the Hemapheresis
Center will be conducting a public awareness campaign in both the
university and the hospital during the next 24 months.

     On a typical day the center is a locus of activity as nurses
and technicians interview potential donors, oversee donations and
provide the coordination necessary to guarantee patients receive
the appropriate platelet transfusions. Right now the center
collects about 70 percent of the daily need. Additional platelets
are purchased from outside vendors that obtain them at collection
sites around the country. Unfortunately, only about half of those
who inquire are eligible to donate, said Brodsky, since
relatively common conditions ranging from high blood pressure to
diabetes disqualify donors.

     At the collection center in a brightly lit open area of the
building, special reclining chairs are arranged in two rows, one
next to each machine. A television hooked to a VCR plays Woody
Allen's Hannah and her Sisters as two donors pay half-hearted
attention. Melisa Dunkes, a registered nurse on the neuroscience
unit at Bayview naps beneath covers on a chair not far from the
television. A gentle nudge from one of the monitoring technicians
wakes her up.

     "I was going to watch the movie but I got bored," Dunkes
said over the steady drone of the machine beside her. "Sometimes
it's nice to just lie here and go to sleep." Dunkes agreed to
come down to the center on her day off after receiving a call
from donor scheduler Debbie Butler, whom she has gotten to know
in the four years she's been making donations. Platelet supplies
were running low and Dunkes' help, she was told, would be
appreciated. So she came.

     "I give as often as I can, and when I forget, they call me,"
said Dunkes, who became a donor when a relative's friend needed
platelets during his treatment for leukemia. Dunkes sports a
"Thanks for Helping Me" T shirt designed by one of the children
who received platelets at the Children's Center. It is, she has
found, a good way to spread the word about the need for
platelets.

     "I tell anyone who is interested about the center because it
is important," she said. "It only takes about two hours of time,
but that's a small price to pay considering you can potentially
keep somebody alive. I tell Debbie to call me whenever it's
slow." Because the machines remove only platelets--a relatively
small portion of whole blood--and return the rest, platelet
donors can safely give as many as 24 times each year. No side
effects are generally experienced and a donor's platelets are
fully replaced by the body within 72 hours of the donation.

     Cancer survivor Nancy Roth talks about the meaning of life,
of sunsets in Maine and a first trip to Oregon and the chance to
see her daughter's wedding, when she speaks before groups on
behalf of the Hopkins Hemapheresis Center. Without the help of
donors like Melisa Dunkes--all of them strangers and most of whom
she will never meet--Roth and many others like her would have no
hope for survival. It is, she says, the true miracle of medicine,
more startling and profound than the technology that made it
possible to give one's healthy platelets to someone who
desperately needs them.

     "On each occasion I wondered if there would be platelets
available to me, and every time there was," she said. "I learned
that there are just some people good enough to make this gift,
even during the holidays or at times when it might not be
convenient. It gives you hope."

     Individuals willing to help fight cancer by donating
platelets should contact the Hopkins Hemapheresis Center at
(410)955-8463.