To Save a Life: Stem Cell Donor and Recipient Embrace in Austin
By Rebecca S. Cohen
“I am Adam,” says Judy Waxman with an enigmatic smile. “My cells are all his. My DNA is all his. My blood type changed from O+ to A+ which is his blood type.” She laughs, “I have everything but the whiskers.”
In December 2013 Waxman was diagnosed with acute myeloid leukemia, a potential death sentence. The transfusion of 22-year old New Yorker Adam Zimilover’s stem cells into her blood stream the following February provided the reprieve that Waxman and her family longed for. And yet, despite the intimacy of this exchange, the anonymity of donor and recipient were preserved by MD Anderson Cancer Center for a full 12 months following the stem cell transplant. After a year, both chose to complete detailed consent forms affirming they were willing to meet, and on June 7, Zimilover and his wife Maddie flew to Austin.
Waxman says, “It’s a year I wouldn’t have had without the transplant. I wanted to meet this person. I wanted to hug him and thank him in person and know who I am in the inside.” Waxman was permitted to write a note to the donor prior to the transplant in which she described herself as a mother and grandmother, but it was scrubbed of specific details such as her fundraising work for nonprofits that might have identified her. Three months following the harvesting of Zimilover’s cells, the letter was forwarded to him.
“When we got that letter, we both cried,” he says softly squeezing his wife’s hand. It arrived shortly before their wedding day in May 2014 following his graduation from Yeshiva University and prior to her final year at Stern College. “My whole family was crying. Before then you’re trying not to make it real, I guess, because you don’t want to feel bad if it doesn’t work. All I knew was that it was a 60-something year old woman.” He also knew she was most likely Jewish. According to the Gift of Life Bone Marrow Foundation website, a patient’s best chance of finding a genetic match lies first with siblings and then with those of similar ethnic background. Zimilover was updated from time to time, told that “the transplant was successful with complications as expected for this procedure.” In other words, that the patient was still alive.
Gift of Life, based in Boca Raton, Florida was founded by a man named Jay Feinberg after his recovery from leukemia following a stem cell transplant. A tissue match was found for Feinberg only after friends and family organized a four-year donor recruitment campaign. Their effort resulted in the enrollment of tens of thousands of new, primarily Ashkenazi donors in the international data bank. Gift of Life has made great strides in continuing this work within the Jewish community.
“Everyone I know, I think, has been swabbed,” says Zimilover who became a donor when Gift of Life set up a table on visiting day at Camp Moshava, a religious Zionist camp where he was a counselor. Potential donors must be at least 18 years old, but Gift of Life allows 17-year olds to pre-register. Mattie pre-registered and says that a package with swab, the requisite forms and return envelope arrived at her home precisely on her 18th birthday. Ideally donors are no older than 44. Although people may remain in the donor bank until they reach 60 the risk to the donor increases with age and the effectiveness of the transplant declines.
Swabbing the cheek—the first step in determining compatibility is easy, painless and quick. Willing donors can register online at giftoflife.org or bethematch.org and become part of an international stem cell data bank. Additional general information can be found at www. cancer.org or by calling the local American Cancer Society. In support of the Waxman family, friends Kristi Katz, Emily Kruger and Amy Hyman spearheaded a stem cell donor drive through the Jewish Federation of Greater Austin Women’s Division on the Dell Jewish Community Campus and swabbed more than three dozen potential donors. “Everybody should swab,” says Zimilover, and there is no effort made to coerce eligible donors to participate further.
In December 2013 as he was finishing his final semester of school and planning a wedding, Zimilover got the call saying that his tissue sample showed he might be a potential match for someone. “I was really excited,” says the pre-med major. He begins his studies at Jefferson Medical College in Philadelphia this summer, and for the past year he has been working as a Study Coordinator for the Program for Jewish Genetic Health at the Albert Einstein College of Medicine conducting a clinical research study on the BRCA gene. After a blood test reconfirmed the match Zimilover was given an intense physical examination and a series of Neupogen shots to increase stem cell production leading up to the date selected for the transplant. The actual donation took place at New York City’s Weill Cornell Medical Center on February 24, 2014. He reclined for five to six hours with an IV in each arm allowing his blood to be cycled through a centrifuge to remove stem cells, and then returned to the body. “It was nothing,” insists Zimilover, despite the flu-like symptoms and mild bone ache that accompanied the Neupogen shots. He missed only one day of school. “You’re in in the morning and out in the afternoon. I’ve donated platelets and blood before. The actual donation is very similar.” He speculates that because, in the early days of stem cell transplantation, bone marrow was drawn from the hip using a more invasive process, some people may remain hesitant to enter the database. In fact a small percentage of stem cells are now harvested in this manner.
Waxman’s discomfort was more protracted than her donor’s. In advance of the transfer, her own white blood cells were destroyed through intense chemotherapy. After the 20-minute long transfusion of new cells on February 25, the hospital staff sang a round of “Happy Birthday” before the truly hard work began. Neuprogen shots followed to stimulate blood cell production and anti rejection drugs even as the patient was encouraged to sit up or walk the majority of each day. She lived in or near MD Anderson for seven months before returning home to Austin, and when that time came she was nervous about exiting the safety of her hygienic Houston cocoon. She mastered the “air hug,” keeping everyone but family at a safe distance because her immune system had been and is still compromised. She was uncertain if she should risk embracing the young man whose gift had given her a second chance at life.
“Hello. Are you Adam Zimilover? This is Judy Waxman.” She had called the moment she received his contact information to set in motion plans to meet. The voice on the other end said “Yes. Can I call you back” She worried she had blindsided him.
“I was on the phone with a patient at work,” corrects Zimilover from the comfort of a living room chair in the Waxman home. He called her back as soon as he could. “It was real exciting, totally out of the blue, I guess.” Having been provided no personal information about the recipient for a full year, he had been less focused on who would be on the other end of the line than whether there would ever be a call. He needn’t have worried.
Adam Zimilover’s stem cell donation made it possible for Judy Waxman to survive the first and most dangerous year of her recovery. Her family regards his action as a mitzvah that every member of the community between the ages of 18 and 44 should be open to performing.
“Whoever preserves a life, it is as though he had preserved a whole world,” says the Talmud, and because this young man gifted his stem cells, the Waxman family’s world has indeed been kept whole. Judy’s son Alan and his wife Charlotte arranged to meet Adam and Maddie Zimilover in New York City to offer their thanks. Siblings Molly and Joel arranged to visit with the couple in Austin. Husband Bill drove to the airport on Sunday, June 7 to retrieve the young couple, but it was Judy who ventured inside the terminal and waited alone at the bottom of the escalator, sometimes crying, watching for the faces she’d memorized after finding them on the Internet. She spotted Maddie waving and raced toward them. There was no “air hug” but rather a tearful, joyous spontaneous embrace for the other Adam.