With the establishment of the HLA Laboratory and the convocation of the International Conference on Bone Marrow Data Bank and Transplant, the existence of the Tzu Chi Taiwan Marrow Donor Registry means more than just a bridge between the marrow donor and the recipient. In the future, the registry will broaden its function to include the study of human genes so as to be more beneficial to the patients. In the last three years, the registry has continuously run for those who have contracted blood diseases, called on people to donate their marrow and promoted international cooperation. To blood cancer patients who have survived because of marrow transplants, their second life must be more precious than their first. Not everyone has the opportunity to challenge his life. Would you like to help those patients challenge theirs?

Story I: Return to the Stage of Life

In those days of fighting against the cancer, he seemed to be walking through a dark tunnel. He hoped to reach the end and see the light soon, yet he was afraid the darkness would never end.

Walking to the front of the stage with firm steps and a broad smile, Jos* Carreras, one of the most renowned tenors in the world, was not going to sing for his innumerable fans this time. In his hand was a check for NT$207,000 (US$7,500), donated on behalf of Swiss watchmaker Chopins to the Tzu Chi Marrow Donor Registry. The money was 10% of the proceeds from the sale of 12 souvenir watches made in Carreras' name by Chopins.

Perseverance Conquers the Devil of Leukemia

On September 16, 1988, the Vienna Opera House in Austria was filled with an excited, emotional atmosphere. Having miraculously overcome leukemia after a two-year fight, Carreras reappeared on the stage of the opera house. This time, his singing was especially moving, because his spirit in challenging the devil of blood disease had touched the hearts of countless people.

"Why me?" That is the first reaction of most people when told they have contracted leukemia. As famous as he was, Carreras had to use all his vitality to fight against this disease, just like all the other victims of blood cancer.

In the summer of 1987, at the zenith of his singing career, Carreras felt easily fatigued. Just like other blood disease patients at their initial stage, he thought he would be all right if he could just have more rest. Thus, he overlooked the early warning.

He never expected that an inflamed tooth would show that he had been afflicted by blood disease. When the doctor made the diagnosis, Carreras felt like he had been struck. In the following two years, he stopped all his performances and used all his strength to fight the disease.

He received chemotherapy twice in succession. Pneumonia nearly took his life. He couldn't find a volunteer marrow donor, and he had to stay for a long time in an aseptic room to receive radiotherapy. He fixed his hopes on an autologous transplant. He was not only physically tortured, but he was also spiritually frightened and depressed.

"I would scream that I couldn't stand it, but I never gave up. If the chance of curing the disease were only one percent, I would be lucky enough to be that one percent." As it turned out, he succeeded with the strength of his optimism.

Rushing About for Victims of Blood Diseases

Carreras described those days of his illness as "traveling through a tunnel." After going through the darkness, he finally saw the light at the end of that tunnel. After a successful autologous transplant, he encountered many other crises. However, with the help of doctors and the encouragement of his family, he conquered them all.

Later when he had recovered, Carreras carried out several plans he had had in mind. He founded the Jos* Carreras International Blood Cancer Prevention Foundation, he helped hospitals improve their facilities for treatment of blood disease patients, and he subsidized a research organization for the study of blood diseases, with the hope of benefiting those who had suffered blood disease as he had, especially the afflicted children he saw during his hospitalization.

Because of his disease, Carreras reevaluated his life. He became happier and more easily contented. He reduced the number of concerts and rushed about raising funds for blood disease victims. "As long as there is one patient who gets encouragement and faith from my story, then all that I have done has been worthwhile."

Story II: "Princess White Blood Cells"

Childhood should be a colorful time when children chase each other under the sunshine, but to children with blood disease, it is a dream beyond reach.

Before the little girl went to sleep, her mother told her the story of Snow White. The little girl thought for a moment, and then said, "Mama, I'm also a Princess Snow White because my disease has something to do with white blood cells." Her mother nodded, with an ache in her heart.

Little Patients

According to statistics, an average of 1,000 patients each year are afflicted with blood disease. Of these, 500 need non-relative bone marrow transplants. Among them, there are young children struggling on the verge of death.

The children may be at the age of two, five or ten. Their common characteristic is that they all wear respirators, travel between home and hospital periodically, or make the hospital their home. In this white limbo, they slowly spend their childhood. To these children, growth is a far-off, unknown future.

Among the 50-odd patients who have received non-relative marrow transplants through the Tzu Chi Bone Marrow Donor Registry, there are quite a few children. They were lucky to have found donors with matching tissue type.

Before these children received the healthy marrow, they had to stay in an aseptic room to receive high doses of radiation to kill all the cancer cells. In spite of all the dolls and toys in the aseptic room or the exciting cartoons on the TV screen, the calendar on the wall was what interested the little recipients the most. Their mothers said they could cross each day out until they reached the date with a circle. Then they could leave the small room.

Hoping to Grow

"Now we know how important it is to have a physical checkup before marriage," sighed the mother of a child with Mediterranean anemia. Both she and her husband were recessive carriers of the disease, and they unknowingly passed it on to their child. Such little children bring their parents endless regret.

In the children's cancer ward, children who should be shouting and running after each other under the sunshine instead walk with metal stands on which are hung their IV bottles. Or they wear big, heavy respirators and play carefully with nurses and volunteers. They must wait * wait to find a donor with a matching HLA type. Only after that can they fly high. They have a long way to go.

Story III: Who Will Donate the Marrow?

"When my marrow was extracted for the test, my parents were worried about my health. How likely was it that a stranger would donate his or her marrow to me?"

Yang Yung-sheng had an ordinary, well-to-do family: loving parents, a nice wife and two lovely children. Having just finished his two-year military service, he had many plans for his future: to make money to send his children to the best schools, to save enough money for his family to lead a better life without any worry, etc. The words "blood cancer" were not in his plan. However, leukemia unexpectedly came to him in 1994.

When 25-year-old Yang was proven to have contracted chronic myelocytic leukemia, the doctor in the Veterans' General Hospital in Taipei started to look for a suitable marrow donor for him. Since the tissue type of his brothers and sisters was not compatible to his, they sent an application to the Tzu Chi Bone Marrow Donor Registry. Yang himself did not hold any hope at that time. "My parents were worried about my health. How likely was it that a total stranger would be willing to donate his or her marrow to me?"

An Additional Life Plan

Yang was still working in his office. Occasionally he would slip away for a moment to have another look at the world that he might not see much longer.

"Without a marrow transplant, he had only three years to live ," said Dr. Chen Po-ming, Yang's attending physician. "But we dared not tell him the truth because that would have been a heavy blow to him. We didn't tell him until we had found a donor with matching HLA. That's the way we generally handle such a case."

Yang made up his mind to accept the transplant. His wife had been looking after him without rest. His parents had been coming to see him every morning after they had taken his children to school. At noon, they had to rush back to pick the children up. In the afternoon, they came to the hospital again to bring him some nutritious food. Sometimes in the middle of the night, if they could not sleep well, they would come to the hospital to see him. His father had suddenly seemed much older. All this made Yand sore at heart.

"Without a marrow transplant, I might be able to live five years more if I was lucky enough. But I might also die the next day. How much more did my family have to suffer and worry about me? In order not to burden them any longer, I decided to accept the transplant as early as possible. Besides, the later the transplant, the less likely it would be to get a cure."

During the observation period after the transplant, Yang had high fever and his white blood cell count dropped below 1,000. Doctors did all they could to save him. Because his white blood cell count rose very slowly, he stayed six months in the hospital. His most unforgettable experience was spending the Chinese New Year in an aseptic room. The nurse greeted him, saying, "Happy New Year! I've prepared you a dinner of 20 pills!"

You've Saved Our Family

In the middle of May 1995, Yang was finally discharged from the hospital. His philosophy of life completely changed. Having seen death too many times in the hospital while taking care of her husband, Yang's wife said to him, "We put too much stress on money. Life is only a few decades. It's more important to do good deeds." Yang told his wife, "When our children grow up, we'll do volunteer work at an orphanage."

Maybe people learn to appreciate what they already have when they face death. Yang's attitude toward his children's education changed too. "I used to hope that they would study hard, make big money, marry good wives and breed a remarkable next generation. Now I realize the next generation should not be limited to my own children only."

Born optimistic, Yang never has any pessimistic view on marrow transplant. Now he frequently goes back to the hospital to encourage other blood cancer patients who are hesitant to take marrow transplants. He says to them, "Never think about what will happen if the transplant fails. Just think about what you are going to do when you survive."

Of course, the person he was most grateful to was the donor he had never met. On August 3, 1996, Yang finally met the donor. "I'm so grateful to you. You've saved not only me, but our whole family."

Story IV: Tug of War Against the God of Death

Originally he was worried that what he was going to learn might not be useful. His professor's words showed him that it was just because blood disease was incurable that he had to study it.

When Dr. Chen Po-ming went to study hematology in Japan more than 20 years ago, his counselor said to him, "You have to do what others don't want to do and study what others don't want to study."

At that time, the salary of a Taiwanese government employee was less than NT$2,000 (US$50) per month. One shot of medicine against blood cancer cost more than NT$1,000. So, people considered the disease to be incurable.

Dr. Chen, who has fought blood cancer and challenged life together with blood cancer patients for more than 20 years, said that he accepted his professor's suggestion reluctantly. The first year of his study was very hard. Besides, he was worried that what he was going to learn might not be useful, because people at that time just couldn't afford to have the disease. From the second year of his study, however, he found out that there were many things he could do to help patients.

Dr. Chen pointed out that blood cancer was originally thought to be incurable, but with advances in hematological research, patients' lives could be prolonged and finally the disease could be completely cured. Especially after the establishment of the Tzu Chi Bone Marrow Donor Registry, non-relative marrow transplants could be more readily performed.

"A patient's life, which originally couldn't be saved, can be saved now. It is an accomplishment, a satisfaction." In the past, only 25% of blood cancer patients could be saved. Now with non-relative transplant, 75% or more can be cured.

No Gain and No Loss

In the course of saving lives, Dr. Chen has realized even more the value of life. Therefore, he frequently urges blood cancer patients to get a marrow transplant as soon as possible, because once the opportunity is gone, the possibility of success diminishes.

The percentage of success never satisfies patients. Therefore, Dr. Chen tells his patients that they have nothing to lose. If the transplant is successful, the patient will gain a new life. If it fails, he may lose just a little because without the transplant he may live only a little longer. If after the transplant, he should still pass away because of other complications, then he would neither gain nor lose. "A bone marrow transplant is the only chance for a patient to survive. We have to do everything to urge him to accept."

Challenging Life