Blood Disorder Detour

Keck Medicine of USC
Univeristy of Southern California
Keck Medicine of USC
Keck Medicine of USC
Keck Medicine of USC is the University of Southern California’s medical enterprise, one of only two university-owned academic medical centers in the Los Angeles area.

Blood Disorder Detour

Post-surgical/trauma nurse Sharon Dunn led a quiet, normal life – that is, until, in her mid-60s, she developed a blood disorder called myelodysplastic syndromes (MDS).

In the three years since her diagnosis, Dunn’s life had taken a series of twists and turns, including major transplant surgery. Thankfully, her dedicated hematology team at USC Norris Comprehensive Cancer Center, part of Keck Medicine of USC, helped her navigate the disease, beating it despite the odds.

MDS is actually a collection of disorders that leads to the ineffective production of blood cells. This can cause anemia, a condition where the body doesn’t get enough oxygen due to a lack of enough healthy red blood cells. The severity depends on the type of MDS a patient has and his or her response to treatment. Many patients can control MDS through medications, but there are some, like Dunn, for whom medications aren’t effective.

By the time Dunn first saw Casey O’Connell, MD, assistant professor of clinical medicine at the Keck School of Medicine of USC, she and her doctors had already tried three different medications that all failed to control her MDS. Dunn was constantly exhausted and often short of breath. She found herself scheduling her hours working at a Santa Barbara hospital with a day off between shifts to rest and recover.

It was during her first visit with O’Connell that she received the really bad news: “Dr. O’Connell said I needed a bone marrow transplant,” said Dunn.

At Dunn’s age (then 68), bone marrow transplantations can be dangerous, according to O’Connell, who says that patients in their late 60s typically have other age-related problems that make recovery from this form of treatment difficult. Even under the best of circumstances, O’Connell noted, there is a 20 percent chance an older patient will die from a bone marrow transplant.

Even so, bone marrow transplants can be effective. O’Connell believed that Dunn, with her excellent kidney, liver and heart functions, would pull through.

But then Dunn developed acute myeloid leukemia, a complication of MDS, putting her life and her shot at a bone marrow transplant at risk: Leukemia that develops from MDS is resistant to treatment. “Her prognosis at that point was not good,” O’Connell said, noting that most MDS patients who develop leukemia do not live longer than six months.

On the Right Path

With expert care from her Keck Medicine team, Dunn survived the bout of leukemia and went into remission, allowing her doctors to move forward with her transplant. Although none of Dunn’s relatives were a match, her team was able to find an unrelated match.

First, Dunn underwent a course of chemotherapy at USC Norris to destroy the cancerous cells. On May 25, 2013, Dunn received a bone marrow transplant, a process that involves injecting donor stem cells through an intravenous line. The donor cells eventually make their way to the bone marrow cavities, where they begin creating new bone marrow and stem cells, typically within a month of the transplant. These new cells start to produce new blood cells; in some cases, the new blood cells may also attack and destroy any cancer cells that survived the treatment.

Once again, however, Dunn had difficulty — she developed an immunologic complication that required her to receive frequent blood transfusions. O’Connell and the Keck Medicine team have extensive experience in handling complex cases, and they continued Dunn’s blood transfusions for five months until the complication was resolved and her bone marrow began regenerating on its own.

That’s when things began to change for the better.

“The color came back into my skin – I started climbing the stairs in my condo a lot more easily, too. I had an excellent experience with my doctors and medical team at Keck. They were all wonderful to me.”

For the first time in a long time, Dunn is starting to think about her future and even make a few plans. Though she hasn’t worked for a year because of the MDS, Dunn is considering a return to nursing. She is also planning a trip — a drive up the West Coast to view historic lighthouses.

Dunn has even greater plans. There is someone she’d like to thank in person — her donor, who Dunn has learned is a young German woman. Legally, more information
can’t be revealed until two years after the operation. “You can guess where I’ll be going on May 25, 2015.”

–By Hope Hamashige