Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, October 11, 1994 TAG: 9410110105
SECTION: SPORTS PAGE: B1 EDITION: METRO
SOURCE: SCOTT BLANCHARD STAFF WRITER
DATELINE: BLACKSBURG LENGTH: Long
It's a harmless isn't-that-something statement, but it can bare a lot of sharp teeth.
``They basically kill you and bring you back,'' said Peg Morse, who watched it done to her husband three months ago.
Virginia Tech trainer Jimmy Lawrence underwent a life-threatening procedure at the University of Nebraska Medical Center during which diseased blood cells were replaced with healthy ones.
He - or they, as Lawrence would say - did it to rid him of his non-Hodgkin's lymphoma, a cancer he first contracted in 1984. Lawrence said he thought intensive chemotherapy in '84 had killed the cancer until it came back in his neck two years ago.
An infection in a catheter through which Lawrence still receives medication temporarily put him in a Roanoke hospital two weeks ago. But Lawrence, the head basketball and baseball trainer who's been at Tech for 14 years, wants to be back on the job in time for Tech's ``midnight madness'' basketball practice, festivities for which begin 11:25 p.m. on Oct.14, Lawrence's 38th birthday.
That he returned for a day in August was enough for some people. Tech head trainer Eddie Ferrell just about broke down when Lawrence showed up, tan from radiation and looking much healthier than he did in '84.
``Just joy. I felt wonderful,'' said Ferrell, a 24-year Tech employee. ``I think the difficult thing for me is that he's been through it before. Here he goes twice; it doesn't seem fair. In this department, I don't know of many people who do a better job or, to me, would be more missed than Jimmy Lawrence when he's away from his job.''
Lawrence had a more taxing task in Omaha. During the procedure, doctors removed Lawrence's bone marrow, culled healthy blood stem cells from diseased ones, and put the good ones - what Lawrence's doctor called ``[bone]-marrow seeds'' - back in Lawrence's bloodstream. They're supposed to settle in his bone cavities, start making more disease-free cells and build new bone marrow.
That's exactly what happened with Lawrence, an Elliston native. But for a week or two after the transfusion, almost non-existent blood-cell counts leave a patient susceptible to major complications from even minor infections.
Morse, Tech's promotions director who married Lawrence in 1989, oversaw Lawrence's recovery and did some of her own work out of an Omaha hotel room. Lawrence said Tech athletic director Dave Braine put Morse's family ahead of her Tech job. Daily, Lawrence said, there'd be a card or two from Tech folks, and the E-mail box on Morse's computer always was stuffed with well-wishes.
``You know all these people, and you see 'em, and you watch 'em work, and then when something really bad happens, it's just so great to know that they were just like the guy that lives next door,'' Lawrence said.
Morse feared the stigma of cancer or of a bone-marrow transplant would keep people silent.
``They don't want to look at you, they're afraid, they don't know what to say,'' she said. ``I haven't faced much of that. I get asked 50,000 times a day how he is. They've been great.''
The well-wishers helped Lawrence and Morse cope, for example, the day he left the hospital, two days after the transplant. He got sick in the car. And the days he lay in bed, on intravenous liquid nutrition, as Morse watched, worked, nursed and hoped the transplant would take.
As Lawrence recovered, he couldn't even brush his teeth (too much bacteria on the brush). He had to swab saliva, made thick by radiation therapy, with a sponge. A man undergoing the same procedure at the same time as Lawrence died because an old ulcer began to bleed; with no platelets, there was no way to clot the blood and stop the bleeding.
``The big day was the 10th day after the transplant when my white [cell] count came back,'' Lawrence said.
The normal white blood cell count (a measure of the number of cells in a certain amount of blood) is between four and 11, Morse said. Lawrence was at zero after the procedure.
``On Day 10 it came up to, like, one,'' Morse said. ``It was like, `Oh, my God!' You just have to see those numbers. It worked ... And what if it didn't? Nobody wants to say what if they don't take. They never ever tell you, because basically what happens is, you die.''
UNMC doesn't like to hear that. The Omaha-based facility claims it does more autologous bone marrow transplants - in which the patient's own marrow is used, instead of a donor's - than any cancer center in the world. Lawrence's doctor, Phil Bierman, says the mortality rate from complications resulting directly from the procedure has dropped from 25 percent 11 years ago to less than five percent today.
One of the reasons is the increasing use of a drug that promotes white-blood cell growth, shortening the time a patient has to spend in isolation for fear of infection. Lawrence participated in a study in which the drug, called GM-CSF, was given several days after the transplant (instead of the day of the procedure) to minimize its possible side-effects (fluid in and around the lungs and heart) and save hospitalization costs. In Lawrence's case, it worked.
``We've only been doing this for a little while,'' Bierman said. ``It's certainly not Nobel Prize material.''
People like Lawrence and Morse - whose grandfather died in 1975 after a bone-marrow transplant in Omaha - might feel differently. Bierman said the success rate is ``probably about one-third'' - success defined, he says, as ``long-term disease-free survival.'' More chemotherapy, Lawrence was told this summer, probably would have set his cancer back but not kill it.
``We think this is the best chance to cure this,'' Bierman said.
That's why Lawrence did it. He had to qualify for it - general good health, relative youth, and so on - and once he was approved, he didn't waver, even when doctors started listing the possible side effects: kidney failure, heart problems, lung problems, possibly even leukemia from the high doses of radiation given before the transplant.
``They're big on informing; they want to make sure you understand what you're getting into,'' Lawrence said. ``But it's the best thing to do. Why try to do a patch job on it now when you can maybe fix it permanently?''
Of Lawrence, Bierman said: ``We hope for the best. He did as well as anybody does.''
by CNB