Long Road for Holan Has Simple Beginning
The extraordinary thing about Milos Holan’s moment of high drama Wednesday morning was how ordinary it seemed when it arrived.
At about 4 a.m., in a quiet hospital room at the City of Hope National Medical Center in Duarte, a nurse started the transfusion of about a liter of bone marrow--the gift of an anonymous donor--into a catheter in Holan’s chest.
It looks almost like an ordinary blood transfusion, but Holan, with his pregnant wife, Irena, at his bedside, was receiving the life’s blood that can cure his leukemia.
“It has such emotional significance, even though it does not look very dramatic,” said Dr. Stephen Forman, the director of hematology and bone marrow transplantation at the City of Hope who is treating the Mighty Duck defenseman.
“I learned from patients many years ago that they separate their life into two lives: Life with cancer before the transplant, and life without cancer from the date of their infusion on. After the infusion, they are leaving cancer behind.”
Holan, 24, was listed in stable condition after the three-to-four-hour procedure, but his battle is far from over. The next 3 1/2 weeks will be critical to his recovery.
His immune system was destroyed by a weeklong regimen of radiation and chemotherapy to rid his body of diseased marrow before the transplant. Until the donor’s healthy marrow takes hold and begins to build a new immune system, Holan is susceptible to infections and other life-threatening complications and must remain in isolation in a room with a special air-filtering system.
Patients typically remain hospitalized about six weeks, though it can be much longer if there are complications, and they remain under a close watch for the first few months at home. Many patients begin to feel better after about six months, but full recovery is considered to take about a year.
The sports world has seen dramatic cancer recoveries in recent years by the Pittsburgh Penguins’ Mario Lemieux, who was treated for Hodgkin’s disease and has returned to dominate the NHL, and golfer Paul Azinger, who has returned to competition after being treated for lymphoma.
Holan has understood from the beginning that his case is more serious, and when people in hockey circles mention Lemieux, he has politely and quietly told them, “This is different.”
“This is much more difficult and much more risky,” Forman said. “The question in this case is survival.”
A patient such as Holan, found to have a slow-progressing form of leukemia after a routine blood test during a physical in September, has about a 60% chance of a cure with a transplant from an unrelated donor.
Without a transplant, doctors told Holan, his condition would almost certainly be fatal.
Holan’s only sister, Radka, was not a match, and doctors began searching the National Marrow Donor Registry for a compatible donor. Publicity surrounding the illnesses of Holan and Rod Carew’s daughter, Michelle, who also has leukemia, have helped push the list of registered donors past 2 million. In January, four months after his disease was discovered, Holan learned a donor had been found.
“Some people wait their whole life for a donor, and some people die,” Holan said at the time. “I’m the lucky one.”
Defenseman Randy Ladouceur, Holan’s roommate on the road when Holan played 16 games this season as the search for a match went on, said the players have been optimistic.
“We were sure they’d find a match, and maybe we really don’t know how lucky he is to have found one,” Ladouceur said.
The marrow that can give Holan a new life was extracted from the pelvis of the donor during an hourlong surgical procedure in another city, then transported to the City of Hope, where Holan was waiting.
Under National Marrow Donor Program guidelines, the donor remains anonymous for a year, to diminish the emotional pressure on the donor or recipient. But after a year, Holan might have the opportunity to meet the person who will have saved his life.
“With an unrelated donor, the transplant is even more dramatic because of it requires coordination with another place and another person,” Forman said. “A person you don’t know acts almost out of civic responsibility, for the good of mankind, as opposed to a family member. We know that somewhere today there is a donor going home knowing that they gave a transplant to someone in Los Angeles.”
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What’s Ahead for Holan
Doctors discovered Mighty Duck defenseman Milos Holan’s leukemia after an abnormal blood test in September. Holan has a form of the disease that, without a bone-marrow transplant, would eventually be fatal. Marrow, the soft, fatty tissue found in bone cavities, is the body’s “blood factory.” A look at how his treatment is expected to progress.
* Feb. 12: Holan enters City of Hope National Medical Center in Duarte for an intense weeklong regimen of radiation and chemotherapy to destroy his diseased bone marrow.
* Feb. 21: On “Day Zero,” Holan receives about 1 1/2 pints of marrow from anonymous donor. Marrow, extracted from donor’s pelvis enters Holan’s body through a chest catheter in a process similar to a blood transfusion. The process takes about four hours.
* Day Zero plus 14-21: Holan remains in isolation to guard against infections and other serious complications and allow close check on his blood counts to see if new marrow is beginning to build a healthy immune system.
* Day 14/21--Day 35/40: Once new marrow has shown signs of “engraftment,” Holan moves out of isolation, but remains hospitalized for several more weeks. Average patient leaves hospital after six weeks, but remains under recovery watch at home for several months. Full recovery takes about a year.
Source: Times reports; Researched by ROBYN NORWOOD / Los Angeles Times
