The gift of life is a two-way street

DAEJEON － Lee Mi-ok, 32, vividly remembers a phone call she received late last November. "It was in the afternoon, and a coordinator from the Hemopoietic Stem Cell Bank in Seoul said she needed to confirm my husband's pledge to donate bone marrow."

The coordinator had been unable to reach Ms. Lee's husband, Hwang In-ho, 34, on his mobile phone for about three months, so had to break with policy and call Mr. Hwang's home phone because of the urgency of the situation: A patient requiring a bone marrow transplant was running out of time. The center's normal procedure bans contacting anyone other than the registered donor, a precautionary measure aimed at reducing the number of donors who back out due to opposition by family members.

But Ms. Lee's reaction was different. "I felt like a load had been lifted off my chest," she said. "I said, 'Of course he will do it,' without even asking my husband."

The couple had good reason to feel compelled to donate bone marrow. In the fall of 1999, their son, Min-ha, then 5-years-old, was suffering from what appeared to be frequent colds. When the boy's fever spiked to 39 degrees centigrade (102 degrees Fahrenheit) for more than a week, the small neighborhood clinic, which had treated him for a common cold, referred him to a larger hospital. There, the boy was diagnosed with bone marrow cancer, or chronic myelogenous leukemia. "They told us to go to a university hospital in Seoul," said Mr. Hwang.

At the Catholic Medical Center, Yeouido, Seoul, doctors said that a bone marrow transplant would be the only cure. A search for a matching donor was immediately launched at the Hemopoietic Stem Cell Bank, part of the Catholic University of Korea College of Medicine. At the hospital, Mr. Hwang saw other parents watching their children slowly dying from leukemia, unable to find matching bone marrow donors in time. The experience prompted him to sign up as a donor.

"In a way, we were fortunate that Min-ha had a chronic type of leukemia because we had the time to wait for a matching donor," said Ms. Lee. After a 20-day stay at the hospital, Min-ha was released to go home. The family's hearts jumped each time the phone rang, as they waited anxiously for the call from the coordinator that would tell them that a match had been found.

In January 2000, the Hwangs were told that five matching donors had been found from the stem cell bank, fortunate because the possibility of a match with each potential donor is 1 in 20,000, and there are some 25,000 volunteers registered with the bank. "When we got the green light for the operation, I was so elated I couldn't hold back my tears," Ms. Lee said. "But looking around the hospital, I felt guilty because there were other mothers whose children were unable to find matching donors. Some had searched as far as Taiwan and Japan with no luck. I still remember the look of disappointment on their faces. They were glad for me yet I could see their deep disappointment."

Min-ha went underwent chemo and radiation therapy for a month in preparation for the bone marrow transplant, a difficult ordeal even for adults. Contrary to expectations, Min-ha handled it well and bounced back strong from the transplant. "Because Min-ha was relatively healthy at the time of the transplant, his recovery was smoother and faster than expected, surprising his doctors," Ms. Lee said.

During the two-month hospital stay, Ms. Lee saw 25 children die from leukemia. The fact that her son made it while so many others did not pressed heavy on her mind, a sort of survivor's guilt. Her husband also experienced the sorrowful feeling.

"I feel forever indebted to the donor," Mr. Hwang said. "All I could find out about him was that he was a graduate student at Kyung Hee University."

It was only natural, then, that Mr. Hwang confirmed his decision to donate bone marrow when the call came last November. Nearly two years after he had registered as a bone marrow donor and had his blood drawn for antigen typing, the process used to find matches, Mr. Hwang had mostly forgotten about it. "For the first few months after I registered, I waited for the phone to ring, but I began to think about it less and less as time passed," he said.

As soon as Mr. Hwang gave his assent, the recipient was put on high-dosage chemotherapy and radiation. Mr. Hwang, for his part, was told to stop smoking, drinking and to not take antibiotics. He also made the three-hour drive from Daejeon to Seoul twice to get checkups and to draw blood that would be infused back to him after the surgery.

Taking seven days off from his work at the four-man police station in a middle class suburb of Daejeon, Mr. Hwang checked into Gangnam St. Mary's Hospital in Banpo-dong, southern Seoul, on Dec. 10, one day before the scheduled surgery. He would not get to see the recipient ?identified only as a critically ill 13 year-old boy with leukemia ?who would receive the bone marrow transplant at the Catholic Medical Center. Coincidentally, Min-ha also was at the Catholic Medical Center and his unknown donor was at Gangnam St. Mary''s Hospital for his transplant.

The three-hour procedure on Dec. 11 drew 2 liters of bone marrow from Mr. Hwang, leaving him with two 2 centimeter-long scars on both sides of his lower back. "I remember worrying whether I would wake up from the general anesthesia as I lay on the operating table," Mr. Hwang said.

Two months after the surgery, Mr. Hwang who works 12-hour shifts at the police station followed by a day off, finds himself getting tired more easily and experiences occasional dizzy spells. That despite getting a clean bill of health at a post-operation checkup last month. "I guess I'm not young for a donor, since 40 is the upper limit," he said. Mr. Hwang still remains on the donor list and can be called to share his bone marrow again.

Today, watching Min-ha play with his father and run around like any other playful 7-year-old, it is hard to imagine that the energetic first grader once lay sick in the hospital, his future depending on the outcome of a bone marrow transplant. He has been in remission for nearly two years, and is well on his way to a complete recovery without any additional treatment. Although the parents are very watchful and cautious about Min-ha's health, they say they try to live one day at a time. The couple had a baby girl, Soo-bin, a year ago who now takes up most of Ms. Lee's attention. "If Min-ha does not have a relapse in the first five years after the transplant, he will be considered to have been completely cured," Ms. Lee said.

Naturally, Mr. Hwang hopes the very best for the boy who received bone marrow from him. "I am concerned that my bone marrow may not have been in an optimal state, with my age and all, but I hope that does not dampen his chances for survival," he said.

The Hemopoietic Stem Cell Bank has 25,000 registered donors. As of the end of last year, 250 leukemia patients were on the cell bank's recipient list, waiting for matching donors. Last year, 35 patients received bone marrow transplants through the bank, which is one of the two such registries in the country.

Explaining that the bone marrow registry needs to have at least 100,000 people on the donor list for it to be able meet most of the demand for bone marrow transplants, Mr. Hwang said, "It costs nothing and you can give someone the gift of life."

by Kim Hoo-ran