At age 22, Randy Baird is no stranger to death.
Two years ago he watched his strong, athletic body shrink and stoop like that of a tired old man. His daily routine became one of working and sleeping, working, sleeping.There was little energy for anything else, but no clues as to why he bruised and bled so easily.
The debilitator was finally diagnosed as aplastic anemia, a life-threatening disease characterized by the inability to regenerate red blood cells. But because of procedures done at LDS Hospital, Baird is alive today to tell his story.
"The diagnosis was unbelievable," the now-healthy Ogden resident said. "I never thought anything like that would happen to me at age 19. Maybe down the road . . . "
Baird's treatment options were limited.
A bone marrow transplant, he was told, was not an easy way out - but it was the best possibility to save his life.
He was referred to LDS Hospital, where specialists are battling various forms of immune-system disorders, blood diseases and cancer with bone-marrow transplants.
Since the program was initiated, the bone-marrow team at LDS Hospital has completed about 40 transplants. Long-term survival rates, taking into account age and underlying disease, have compared favorably with those at other institutions.
Dr. Clyde D. Ford, program director, believes the lifesaving therapy will be used to treat an increasing number of children and adults who 20 years ago were given little hope for survival.
A bone-marrow transplant, Ford said, is actually a transfusion, not a surgical procedure. The transplant basically replaces some of the bone marrow of the recipient with the bone marrow of a donor.
The technique permits the use of large doses of radiation and chemotherapy to eradicate malignant tissue, which destroys bone marrow.
"If we are able to do a transplant, we can use much higher doses of therapy to rid the patient of his leukemia," Ford said.
According to the hematologist, there are two kinds of transplants: allogeneic, which is from one person to another; or autologous, which uses the patient's own marrow. Donors are matched by tissue typing.
With the first, an excellent match is required between donor and recipient or there is an increased risk of serious complications. "Far and away the best match is a brother or sister; there's a one-in-four chance they will match," Ford said.
However, transplants with partially mismatched marrow can be done. Specialists now are also able to use marrow from unrelated donors who are matches with recipients. This has opened the door to more potential donors.
Baird's donor was his 11-year-old brother, who despite the painful procedure relished saving his older brother's life.
The marrow, removed through multiple needle sticks from the pelvis, is filtered and processed in the hospital's blood bank. It is given like a blood transfusion.
"Autologous transplants are a much safer procedure, but the risk of infusing tumor cells remains," Ford said. A match, however, is guaranteed.
LDS Hospital is continuing its efforts to make autologous transplants more effective and accessible. Autologous marrow is preserved by slow freezing under controlled conditions. The marrow can be then stored in liquid nitrogen for long periods and thawed and used if the patient has a relapse.
Baird hopes he won't be returning to LDS Hospital, where he became familiar with "isolation." Like other bone marrow transplant patients, he lived for 45 days in a sterile, isolated laminar air-flow room, designed to protect the patients from bacterial infection.
In the specially designed room, carefully filtered and purified air blows over and away from the patient, keeping contaminated air from reaching the transplant recipient. Nurses and physicians are kept "downwind" - outside a plastic curtain enclosure. Sterile techniques are used to serve food.
The science-fiction-like existence is one Baird doesn't want to repeat - and likely won't have to.
The strapping youth's only illness since undergoing the transplant has been a cold that almost turned into pneumonia.
"I've been problem-free for a year and a half," he said. "Maybe 10 years ago I wouldn't have had a chance."