An unexpected turn
In May of 2013, Tose, a Boeing senior manager who also flies small planes as a hobby, went for a routine physical so he could renew his pilot’s license. At 7 that night, his doctor called him to say his blood counts were abnormal.
“I told him I feel fine. It’s obviously a mistake and asked him if they could run the test again,” he remembers. But they already had, his doctor told him. It was no mistake. He had acute myeloid leukemia.
Tose underwent six rounds of chemotherapy, including a final round at Seattle Cancer Care Alliance, and eventually went into remission. But due to an anomaly in his genetic makeup, Tose learned, it was almost certain his cancer would come back — and likely very soon unless he had a peripheral stem cell transplant.
While he has a large and supportive family, cancer has cut a swath through it and so some immediate relatives weren’t eligible to donate and those who were didn’t match.
“I was so scared,” remembers Tose. “… They had told me ‘It is our judgment that your long-term life comes down to getting a stem cell transplant.’ “
His doctors turned to Be The Match, the largest bone marrow registry in the world, which strives to find a donor for patients who don’t have a suitable one in their family.
Soon, Tose learned, someone had been found who matched 10 out of 10 antigens tested for a stem cell transplant. A perfect match.
‘It was literally a cheek swab’
Salmons was a college student at Dickinson College in Carlisle, Pennsylvania, in the spring of 2013 when he decided to give up part of his lunch break to join the registry during a drive sponsored by the school’s football team. “It was literally a cheek swab and 10 minutes later I was done,” he said.
He didn’t think much about it again until the following October when he started getting calls. At first he ignored them, not recognizing the number and believing it was a telemarketer. “Finally I got an email that pretty much said, ‘Please in God’s name give us a call back.’ “
When he did, he learned he was needed as a donor for a man with AML. By then, Salmons was a senior biology major doing a project on leukemia, something a friend had died of when they were both just kids. He was also in the middle of his final season playing lacrosse for his school, something he’d have to interrupt to donate. Without hesitation he agreed. “It was a no brainer to go through with it.”
In the time leading up to the day his stem cells were harvested, he was aware that he carried the key to another life. “I kept thinking, don’t get sick. Don’t get in a car accident.”
Salmons went through more screenings and then, a few days before donating, he had a series of injections of growth factor to stimulate the stem cells. The day of his donation, a central line catheter was inserted and he watched his cells get harvested to be flown across the country to Tose. “It was cool,” he remembered.
His only side effect, he said, was some bone achiness in his hips, back and knees.
“It truly was so easy,” he said.
On Jan. 22, 2014, Tose was in his hospital room at the University of Washington waiting for Salmons’ stem cells to arrive. A blizzard had hit the East Coast and the first flight that was supposed to bring them had been canceled. Tose worried they wouldn’t arrive.
“At that point, you’re on a one-way journey,” he said. “You’re either going to succeed or you’re going to die. You only have so much of a time window.”
Technicians in the lab at Fred Hutch were waiting to process the stem cells as soon as they arrived. They vividly remember worrying about the storm and waiting for the cells to arrive, said Christy Satterlee, a patient access manager at Seattle Cancer Care Alliance, Fred Hutch's treatment arm.
At 10 a.m., Salmons’ stem cells arrived in Tose’s hospital room. He held the IV tube in his hands and watched them flow into his body. His hospital room was decorated with the motto, translated into a dozen languages, that he’d adapted years earlier to encourage his team at Boeing during a stressful time: It’s all good.
On that day, the nurse wrote a new message on the white board in his room: “Happy Birthday!”
Shortly after the transplant, Tose suffered some complications and was sedated and intubated so he’d breathe easier. He woke up in the intensive care unit of the University of Washington on Feb. 10, 2014, surrounded by his wife, brother, doctors and nurses. “I looked up and I said ‘Did it work?’ They told me it did and I cried for a minute. Then I asked who won the Super Bowl.”
Tose was back.
From the moment Tose learned he was going to be given donated stem cells, he knew he’d want to meet the donor someday. But first he had to recover. In June he returned to work part time, then full time in August. But it proved to be too much and he had a bout of graft-vs.-host disease, in which the donor cells attack not only the disease but healthy parts of the body too, and he took a leave of absence from work.
In December, he found out his donor would be open to connecting. Be The Match allows patients to have anonymous contact during the first year, and they are allowed to make direct contact after that year if both parties consent. In February, at the one-year mark, Tose and Salmons learned each other’s names.