Marrow match

Kara MacIver, a 17-year-old Wasilla girl who was diagnosed with chronic myeloid leukemia (CML) in June, got the best news she could possibly receive the night before the Light the Night Walk, which is a fund-raiser for leukemia research.

MacIver attended the walk on Sept. 10 after receiving news from Seattle's Children's Hospital that a match was made for her marrow, and that she'll be able to get a transplant.

"It's really exciting. They called me at home and told me that the donor was for someone else, but that patient had a transplant, but the donor matched perfectly with Kara," said Dawn MacIver, Kara's mother. "It's very, very exciting.

"You start wondering as the days, weeks, months go by," MacIver said. "You try not to, but you can't help but wonder if a match is going to be found."

Kara's sister was a five-sixths match -- she matched five of six antigens -- but a perfect match substantially increases Kara's recovery rate following the transplant.

The only thing standing between Kara and a transplant are some troubling chromosomes, called "Philadelphia Chromosomes." After those chromosomes are eradicated, Kara can have the transplant.

"When she was first diagnosed, 65 percent of her marrow had those Philadelphia Chromosomes," her mother explained. "Right now, we're between five and 10 percent, so she's really getting close."

Dawn MacIver said her daughter's condition essentially boils down to some confused chromosomes. The No. 9 and No. 22 chromosomes break off at the tail end, and get switched, which confuses the body into making platelets uncontrollably.

"The bad chromosomes cause her body to make platelets like crazy," Dawn MacIver said.

Currently, Kara is undergoing chemotherapy to try to get those Philadelphia Chromosomes down to zero. She is on an experimental drug for children -- Gleevec -- which her mother called, "a miracle drug.

"It's been used for 10 years for adults, with really good results," Dawn MacIver said. "Because she was so close to being an adult, they wanted to try it, and it has worked great. It's designed to put her into remission so they can go in and transplant the marrow."

The drug does make Kara sick, her mother said, but it is working -- and that's the most important thing.

Dawn MacIver said a transplant probably won't take place until the spring, for a number of reasons. First off, Kara's body has to kill off those chromosomes. Secondly, Kara wants to finish school.

She is a senior at Burchell High School, and completing high school is important to her. Another thing facing the family is a total renovation of their house.

"You can't have anything in your house that could cause her to get sick. We have to rip up all of our carpeting and put hardwood floors throughout the house because under your carpet, you have black fungus. Even if you have spilled one Coke on your carpet, you've got it," Dawn MacIver said.

"It would probably be January or February at the earliest," Dawn MacIver said. "She's doing well with the Gleevec, but we can't rush into things."

Once the transplant process begins, Kara will go to Seattle for five days of incredibly intense chemotherapy that is designed to kill all of her bone marrow. Then, her donor's marrow will be transplanted, and hopefully within a month, it will graft to her bones. For the next three months following the transplant, she will live in Seattle. Then, for a year, she will have to be a "bubble kid," as her mother explained.

"She can't be exposed to anything that will make her sick. She won't be able to go to school, no restaurants, that kind of stuff," Dawn MacIver said. "Her son won't even be allowed to get his vaccinations, because they are living viruses."

Kara was diagnosed with CML last August, and she had no sign of being ill. She delivered her son, Aaron, through Caesarian section, and she was anemic during part of her pregnancy.

Kara had routine blood tests following Aaron's birth, to monitor her anemia.

In August, a problem was detected.

"In February and March, it was present but they weren't looking for leukemia, and so it went unnoticed," Dawn MacIver said. "Finally, they found it during a routine check-up."