2. Text by Leila Marinho Lage An homage to Helen Breder Rio de Janeiro, 22th, August 2006 My ignorance Click to continue

3. The following information is based on services mentioned in the last slides

4. Years ago, a young lady crossed my path and I discovered her illness: leukemia. We didn’t keep in touch and I thought that she was cured. She isn’t.

5. She has been in hospital to restart chemotherapy and she is waiting for a compatible bone marrow donor to appear to get a transplant. Among the thousands of donors in Brazil and the millions around the world, her donor hasn’t been found yet, but, he exists and will appear.

6. Many people are in the same situation and many others can save lives by donating what can’t have a price – blood cells for transplant. The only condition is genetic compatibility between the donor and the receptor. Donors don’t know who they will donate to and patients don’t know who their donors are either.

7. The search for the right donor is done in Brazil and in other countries. When there isn’t a compatible donor in the family and the patient can’t have autogenic transplant (with their own cells), the authorized services start looking for donors in their databases.

8. Helen had undergone other treatments, but now she needs a transplant. And her relatives aren’t compatible. At this time, she is in hospital to receive strong drugs to control the disease.

9. She would like this message to be carried by a homing pigeon. Out of ignorance, we don’t realize we could save lives, without risks to our own health. Let’s learn a little about leukemia and bone marrow transplant, shall we?

10. The bone marrow is a spongy and soft material which is located in the interior of the long bones, where the organism practically produces all the cells of the blood: red cells, white cells and platelets.

11. These components of the blood are continuously renewed by the bone marrow. It is like a factory in continuous operation.

12. The red cells carry oxygen to all the body. The white cells combat infections, foreign bodies and malign cells. Platelets help blood coagulation and avoid bleedings.

13. In people with leukemia, the bone marrow produces abnormal white blood cells. The abnormal cells are leukemia cells. At first, leukemia cells function almost normally. In time, they may outnumber normal white blood cells, red blood cells and platelets. This makes it hard for blood to do its work.

14. Depending on the number of abnormal cells, patients with leukemia may have a number of symptoms: fever; frequent infections; feeling weak or tired; tiny red spots under the skin; swollen lymph nodes, especially in the neck or armpits.

15. Some times leukemia starts without clear symptoms and the diagnosis may be hard at the beginning.

16. The treatment depends on the type of leukemia, the patient’s age and other factors. It also may depend on certain features of the leukemia cells. Chemotherapy will be used In all types of Leukemia. If the patient requires a bone marrow transplant, then chemotherapy will be stronger.

17. The main objective is to terminate with all bad cells. However, the treatment will also destroy good cells and cause several side effects on main organs. Then the patient will receive stem cells from the donator. The stem cells will spontaneously migrate to the bone cavities.

18. The reproduction of those cells inside the bone marrow of the receptor is not guaranteed, but there is a good possibility, especially when experienced professionals are prepared to conduct all the procedures of treatment and support.

19. How obtain bone marrow cells from donor The objective is to obtain stem cells in your blood. The candidate to donation spontaneously registers in a bone marrow bank and a little sample of their blood is Collected, which is is analyzed, frozen and entered in a bone marrow database. All samples around the world are registered.

20. The simplest way to donate is to have blood collected from a vein, just like in a regular blood donation. This blood goes to a machine where the cells are separated. The other components of blood return to donor, without any risk.

21. When there is no chance to obtain stem cells capable of reproducing the bone marrow, about 200 ml of blood are taken from the pelvis bone of the donor, who will be properly anesthetized. Despite not being the the most comfortable way for donor, it is the usual manner to obtain the necessary material.

22. Only healthy people can be donors and tests are made to guarantee that. The donor will feel a little localized discomfort on during their recovery.

23. The use of stem cells from the umbilical cord is limited. Because the quantity of cells obtained is small, It is primarily originally indicated for children.

24. At any time the donor can give up the donation. Nothing is mandatory.

25. There’s no financial compensation - only the pelasure of saving life and

26. the only reward that can be given to the greatness of this gesture is respect, gratitude and admiration.

27. I hope I have contributed to all leukemia patients and to you, Helen. From your doctor

28. If you live abroad you can also help Go the nearest Blood Center to donate a 10 ml blood sample to be tested for HLA (Human Leukocyte Antigens). The Blood Center will then input the data into a donor database

29. The procedure for the donor is secure and free from risk or danger.

30. The HLA data automatically goes into the International donor database. At this point, the Brazilian recipient database will automatically search for a compatible donor worldwide.

31. The donor needs to be between 18 to 55 years old and in good health.