•

M

aya Rybak and her fami-
ly left their home in
Ukraine eight years ago
in search of religious

freedom.
Today, she finds herself shackled in a
different way by her homeland. When
Rybak was diagnosed with chronic
myelogenous leukemia (CML) 18
months ago, her doctors concluded it
was a result of the nuclear explosion at
Chernobyl.
The Chernobyl disaster of 10 years
ago — two years before the Rybaks
immigrated — occurred only 90 miles
from their home in Poltava.
"I went to my doctor because I had
lost a lot of weight — 35 pounds," said
the 57-year-old Rybak, who now lives
in West Bloomfield. "I was tired all the
time. I went for a physical and found
out [it was CML]."
Rybak's leukemia is being managed
with chemotherapy, but she is in need
of a bone marrow transplant to cure
the disease and has no funds to contin-
ue her search for a bone marrow donor.
"The doctors don't know if it will be
bad, or when it will be bad," she said of
her condition.
"Bad," as Rybak described it, means
moving to the acute stage of the dis-
ease. According to Dr. Jared Klein at
the Karmanos Cancer Institute, it takes
an average of three years after the diag-
nosis for the leukemia to move from
the chronic to the acute stage.
"It's hard to treat once the acute
stage sets in," Klein said. "We can
sometimes get a second or third chron-
ic stage, but it becomes harder to cure
altogether if we don't do it in the initial
stage.
It's chronic because it can be man-
aged with medication for several years."
According to Klein, CML is a dis-
order that begins with the transloca-
tion of chromosome nine to chromo-
some 22.

"

10/17

1997

8

Bone marrow matches are easier to
find among siblings, Klein said, but the
odds are only one in four. Rybak's only
sibling is a half-sister, and therefore she
would not be able to donate because
part of her half-sister's blood comes
from a different father.
"We know for a fact that it's much
easier to find matches within the same
ethnic group," said Rob Schweers of
the Karmanos Cancer Institute said.
"If there are few Jews in the registry,
the chances are slimmer of finding a
match. There are plenty of 'garden vari-
ety' Caucasians in the National Marrow

to give blood again," Goldman
explained. "Then the blood is further
tested to see if it is a match. It costs
$400 to test the blood."
A second search would allow more
potential matches to be tested.
"It will be a problem if we need to
do a third search," Rybak said. "We
may do a Hebrew Free Loan if need-
ed."
Rybak works part-time at a salon in
Farmington Hills.
In order for someone's marrow to be
declared a match, six characteristics, or
antigens, need to be the same.

A Russian emigre
needs a bone marrow transplant
to prolong her life.

LONNY GOLDSMITH Staff Writer

Donor Registry, but we always need
people of ethnicity to get in."
Only 20 percent of the almost 2.8
million worldwide donors in the reg-
istry are minorities.
"The Histocompatibility Leukocyte
Antigen types (tissue types that deter-
mine a match) are ethnically related,"
said Dr. Lyle Goldman, Rybak's hemo-
tologist. "There are certain tissue types
from one race to another."
One of the problems facing Rybak is
finding the money to have the registry
searched. It costs $5,000 per search,
and Rybak already undertook one
before her money ran out. The
Karmanos Cancer Institute has been
searching since last December.
"When doing the search, potential
matches are pulled and they are asked

The allogenic transplant that Rybak
needs is a lengthy process that corn-
bines radiation and/or chemotherapy,
and a recovery period that can take up
to a month or more.
The 7-10 days of treatment destroys
cancerous cells and the bone marrow,
leaving the patient defenseless against
infection. The donor marrow is trans-
fused into the blood stream after the
cancer treatment. It travels to the bone
cavity to replace the old marrow.
Afterward, patients are kept in a
protective environment until the
immune system can rebuild itself. An
increased white blood cell count in 3-
4 weeks means the marrow is working.
If ther. are no problems, the patient
can leave isolated care 3 to 6 weeks
after surgery.

The last year-and-a-half has been a
depressing one for Rybak.
"Of course we were shocked when
we found out," she said. "Now, I'm so
tired I can't do much. I have pain in
my spleen, I don't sleep well at night
and it's hard to do daily activities. I'm —
depressed."
Rybak's medication has taken care
of the pain and the depression, and 0
she feels her doctors are doing their
best.
None of Rybak's relatives with
whom she came to America has had
c.
any health problems. The disease is
not hereditary or genetic, but it still
worries her daughter.
"There is a possibility, but who
really knows," Lana Rybak said. "All
of us who came over are worried."
A Beverly Hills, Michigan-based
group called the Phoebe Foundation
regularly sponsors marrow drives in
which people give blood to be tested
and are entered into the National
Marrow Donor Registry.
"We are trying to get minority
donors in the registry, because of the
compatibility," said Foundation
Executive Director Mary Jane Happy.`'
"Most donor drives code the first
four characteristics (or antigens), and
most matches are confirmed in the last
two," Happy said. "It takes time if th&
last two still need to be checked; and
people don't always have the time to
wait."
Unfortunately for Rybak and her
family, waiting is all they can do.
"The leukemia is stable right now,'`'
she said. "But it's an unpredictable dis-
ease. I still have hope."

❑

For information on bone marrow
drives, call the Red Cross,
1-800-GIVE-LIFE; or Mary Jane
Happy at Phoebe Foundatio
(248) 644-KID

