Sept. 23, 2010

 

Courtesy of Yale Athletics

NEW HAVEN, Conn. -
The long wait is over for Mandi Schwartz, who received the stem cell transplant she needs to beat cancer Wednesday afternoon. The procedure, which lasted 32 minutes, took place at the Seattle Cancer Care Alliance's inpatient transplant unit at the University of Washington Medical Center. With her immune system wiped out by chemotherapy and radiation, Mandi must remain in the hospital and be closely monitored. The next major milestone for her is "engraftment" -- the transplanted stem cells beginning to grow in her bone marrow and manufacture new blood cells and immune cells. This signifies the birth of Mandi's new immune system, and should happen within a month.

The transplant procedure was similar to a transfusion. The stem cells were placed in Mandi's body through a vein, and they will now find their way to her bone marrow to create new blood cells and immune cells.

In preparation for the transplant, which utilized stem cells from two umbilical cord blood units donated anonymously to public cord blood banks, Mandi went through chemotherapy and radiation designed to ensure that all of the existing cancerous cells in her body are eliminated. This also further suppresses Mandi's immune system to prevent her from immediately rejecting the new donor cells.

Wednesday's procedure capped a whirlwind 10-day span, because up until receiving the results of a biopsy on Sept. 13 it was unclear whether Mandi would be cleared for the transplant. She had been battling a series of infections, but when the biopsy results that day indicated that she was still in remission her medical team acted quickly to begin her conditioning for the transplant. The radiation treatment began Sept. 14, and was followed by chemotherapy.

Mandi, a native of Wilcox, Sask., has been battling acute myeloid leukemia for nearly two years. The stem cell transplant essentially gives her the new blood and immune system she needs to survive. Stem cells have the ability to change into any of the body's cell types. In Mandi's case, they will be used to give her new blood cells and new immune cells. Her current immune system, along with the cancerous cells, has been eliminated by chemotherapy and radiation. She will require many transfusions for red blood cells and platelet cells as she recovers.

Complete recovery of Mandi's new immune system takes approximately a year, but could take longer if she develops any complications as a result of the transplant. Following the transplant, she will be monitored regularly through blood tests to confirm that new blood cells are being produced. She will spend several months in Seattle before she can return home to Saskatchewan.

The original plan was to have Mandi receive cord blood that had its number of stem cells "expanded", or increased, in order to speed up the time to engraftment. Because of the results of the recent biopsy, she instead received a transplant from units that did not have their number of stem cells expanded. The biopsy indicated 2.5 to seven percent blast cells in Mandi's bone marrow. Blast cells are immature cells in bone marrow that mature into white blood cells or red blood cells. They normally account for up to five percent of the cells in bone marrow, so a higher ratio than that can indicate a problem.

Prior to the transplant, Mandi took the time to write to her Yale women's ice hockey teammates, who have been among her most active supporters throughout her ordeal.

"I'm praying every day for everything to work out, and I know you all are thinking about me and praying for me - thank you very much - your support means the world to me. I think about the team, your workouts, the busy school day, and the beautiful feeling of stepping out onto that ice every day."

While Mandi continues to battle, the hockey community world-wide continues to rally around her cause. This weekend marks the first annual Mandi Schwartz Challenge at the Co-operators Centre in Regina, Saskatchewan. This tournament will see Alberta, Manitoba and Saskatchewan's Provincial Under-18 teams competing along with the Universities of Alberta, Regina and Saskatchewan. Mandi once played for Team Saskatchewan. The Saskatchewan Hockey Association, along with the University of Regina, will be holding a silent auction throughout the course of the weekend with all funds raised from the auction going to Mandi and her family. There will be no charge for the games; however there will be a place to make donations.

For more information on the Mandi Schwartz Challenge, visit http://players.sha.sk.ca/sask-first/14-u18-sask-first-female