Every day for a year, Avi Ruderman, 54, of Tel Aviv, Israel, wondered, Who saved my life? Every day for a year, Molly Allanoff, 24, a medical student in Philadelphia, wondered, Who got my stem cells, and is he OK?
Molly’s own father had received a bone marrow transplant — but didn’t survive a year. Maybe now she had saved a life, sparing some other daughter the agony of losing her father.
But the bone marrow registry requires a recipient survive a year before he can contact his donor.
So both waited.
At age 50, Avi, who runs convalescent homes with 1,200 beds and 1,000 employees, got non-Hodgkin’s lymphoma, a cancer of the white blood cells. After unsuccessful treatment with conventional chemotherapy, his only hope was a bone marrow transplant. This involves high-dose chemotherapy to destroy the patient’s diseased bone marrow, then replacing it with healthy stem cells from a compatible donor. If the transplant succeeds, the patient recovers and his bone marrow begins making healthy blood cells.
But only 4 in 10 people who need a bone marrow transplant ever get one, partly because finding a match is so difficult. There are 10 markers in the blood of donor and recipient that must match, and each marker has thousands of variations. With 26 million people listed on all bone marrow registries worldwide, Avi had only one perfect match: Molly Allanoff, a medical student at Thomas Jefferson University in Philadelphia.
When he received his transplant, on Oct. 15, 2014, Avi was told only that his donor was a 23-year-old American woman. He would dream about meeting her. He had four daughters. In his mind, she was now his fifth.
Molly was in second grade when her father, Dan Allanoff, a Philadelphia lawyer, first got lymphoma. Treatment gave him 10 healthy years, but in Molly’s senior year of high school, his cancer returned.
The first thing Molly did when she turned 18, in the first semester of her freshman year at New York University, was sign up to be a bone marrow donor. All she had to do was get her cheek swabbed. She knew that fewer than 1 percent of those who sign up ever get called to donate, but she wanted to do her part. The more people who register, the better the odds a sick person finds a match.
In her junior year of college, her father, desperately ill, got a bone marrow transplant. He was so grateful and eager to thank his donor. But Dan’s transplant didn’t succeed, and he died on Jan. 27, 2013, the day before his first anniversary. (The average one-year survival rate for bone marrow recipients is about two-thirds.)
More than 1,000 people came to his funeral. “They all thought they were his best friend,” said Molly. “He had this magical way of making everybody feel important and listened toand heard, always.”
Molly was about to begin her last semester at NYU.She had never taken a science or math class in college but knew immediately after her father’s death that she wanted to become a doctor. She had been so touched by the people who took care of him. “I suddenly couldn’t imagine myself doing anything besides taking care of people and their families,” she said. She enrolled in September 2013 in a post-baccalaureate program at Thomas Jefferson University. It would take two years to complete prerequisites for medical school.
Then in 2014, she got the call from the bone marrow registry.
“I felt so unbelievably lucky,” she said.
On Oct. 14, 2014, Molly, her boyfriend and her mother went to a hospital and for eight hours Molly sat in a cozy chair, with IVs in each arm. Her blood was taken out of one arm, filtered through a machine — much like the process of dialysis for diabetics — and returned to her body through the other arm.
In only 25 percent of cases today, doctors put a needle directly into the donor’s pelvic bone — a surgical procedure requiring general anesthesia — and pull stem cells from the bone marrow. In most cases, like Molly’s, doctors can just filter hematopoietic stem cells from the donor’s blood. For five days before the procedure, she received injections to stimulate production and circulation of blood stem cells, which caused some pain, but she went home the same night, elated, and returned to classes the next day.
Nearly a year went by. During that time, recipients and donors are kept anonymous. This is to protect donors; should patients require a second transplant, the registry wants to protect donors from feeling pressured into undergoing the procedure again.
Two months ago, in September, the bone marrow registry forwarded Molly a letter: “My Dear Donour,” it began, “In October 2014 I received your bone marrow donation. It saved my life and I am most grateful to you. ... I am 54 years old and live in Israel. ... I will be in the U.S. ... to visit my daughter and her fiancé — an NBA player. It would be a great honour for me to meet you … I will cherish your gift all my life.”
There was no name. Molly immediately replied through the agency. When she blew out the candles on her birthday cake a few weeks earlier, she wrote to him, “It was my birthday wish that you were healthy,” and added, “I feel truly privileged to have been able to help you.” On the anniversary of his donation, Oct. 15, Avi dialed Molly. Now a first-year medical student, she was studying for her anatomy final and saw the international number on her phone. She knew.
He had prepared a speech, rehearsed it, but he started crying as he heard the phone ring. When Molly answered, all he could say was, “I’m the one.”
Avi and family flew in from Israel on the afternoon of Wednesday, Nov. 4, and planned to meet Molly in the lobby of the Rittenhouse Hotel in Philadelphia at 7 p.m. Avi arrived first with his wife, Ifat; his oldest daughter, Shani, 26, who is marrying Sacramento Kings player Omri Casspi; and his youngest daughter, Yarden, 5. They sat and waited — but only a moment.
In walked Molly, along with her boyfriend, Andrew Roth, and her mother, Andrea.
Avi swallowed Molly in a mammoth, grateful hug. He is 6 feet tall, and she is 5 feet. Then, after a few seconds, she stepped back. Still holding hands, they looked at each other. “You saved my life,” he told her.
Family members exchanged stories, shared photos, shed tears.
Before going off to dinner together, Avi surprised everyone and invited Molly and her whole family and boyfriend to Israel in June to his daughter’s wedding. “It is my treat, my gift,” he said. “You are family now.”
(Photos and letters above: Courtesy of the family)