In sickness and in health: Husband and wife face back-to-back cancer diagnoses
Carolyn Drone thought her days of coping with cancer were over. She’d finished leukemia treatment two years earlier and showed no signs of the disease.
“Finally, my world was returning to normal,” she says.
But “normal” ended when Carolyn’s husband, Jim, received his own cancer diagnosis.
“It seemed impossible that we had just gone down this path,” Carolyn says, “and now we were starting again.”
Carolyn’s hairy cell leukemia diagnosis
The Drones’ story began in October 2011, when Carolyn was diagnosed with hairy cell leukemia, a rare cancer of the white blood cells. The disease gets its name from the hair-like strands that surround the surface of the cancer cells. The cells look “hairy” when viewed under a microscope.
“This is a very slow-growing type of leukemia,” says Farhad Ravandi, M.D. “Months or even years can pass without any growth. Most patients don’t need to start treatment right away.”
Ravandi monitored Carolyn every six weeks. She had no symptoms and her blood counts remained steady. Treatment wasn’t necessary – yet.
“We kept an eye on the cancer,” Ravandi explains. “If it progressed at some point, we were ready to shift from surveillance to active treatment.”
That day came in the summer of 2013, when Carolyn’s blood counts began to drop. For the first time since her diagnosis, she felt fatigued.
“My husband and I were looking forward to a European vacation in the fall,” she says. “I needed to get my energy back and stop the cancer from growing.”
It was time for treatment.
Clinical trial leads to remission
As luck would have it, Ravandi was leading a clinical trial that was testing a two-drug combination to treat hairy cell leukemia. Carolyn joined the study. For three months, she received infusions of the chemotherapy drugs cladribine and rituxin.
“I had no side effects,” she recalls. “I completed the trial just in time to leave for Europe.”
Two days into her trip, Ravandi messaged Carolyn with good news. Her lab results showed all evidence of cancer had disappeared.
“Jim and I celebrated and enjoyed a worry-free vacation,” Carolyn says. “We thought we’d left cancer behind. But we were wrong.”
The disease begins in the bone marrow – the spongy tissue inside bones. In healthy people, the marrow makes red blood cells to carry oxygen around the body, white blood cells to fight infection, and platelets to help blood clot. But in people with myelodysplastic syndrome, the bone marrow doesn't make enough of these healthy blood cells. Instead, it makes abnormal cells that don’t work properly because they aren't fully developed. The bone marrow gets gradually taken over by these immature blood cells. They crowd out the marrow and prevent healthy blood cells from entering the bloodstream.
Myelodysplastic syndrome can progress slowly or quickly. In some people, it develops into acute myeloid leukemia.
Jim was stunned by his diagnosis.
“I’d gone to my family doctor for a physical and found out my blood counts were abnormal,” he recalls. “I expected to get a clean bill of health. I was in shape and feeling great.”
His doctor referred him to a hematologist, who made the diagnosis.
“I’d never heard of myelodysplastic syndrome,” Jim says. “But when the doctor said ‘blood cancer,’ that got my attention.”
In good hands at MD Anderson
Still reeling from his diagnosis, Jim accompanied Carolyn to her annual checkup with Ravandi.
During that appointment, he casually told the doctor that he’d been diagnosed with myelodysplastic syndrome.
“I can treat that,” Ravandi told him.
Jim felt an overwhelming sense of relief.
“It hadn’t occurred to me that the doctor who successfully treated my wife’s cancer could do the same for me,” he says. “With Dr. Ravandi guiding my care at the top cancer center in the country, I knew I’d be in the best of hands.”
Jim’s myelodysplastic syndrome treatment
Myelodysplastic syndrome is typically treated with transfusions of donated blood, and with medications that encourage a patient’s bone marrow to make more blood cells. If the disease worsens, a stem cell transplant may be recommended to replace the diseased bone marrow with healthy bone marrow from a donor.
Jim’s blood counts remained steady at first. But six months after his diagnosis, the number of red blood cells in his body plummeted. Ravandi ordered a transfusion of donated blood. For the next three and a half years, Jim returned to MD Anderson for monthly transfusions.
“My blood counts went up and down like a roller coaster,” he says.
Ravandi prescribed the drug Procrit to stimulate Jim’s bone marrow to make more red blood cells, and the chemotherapy drug decitabine to lower his chance of getting leukemia.
In the midst of it all, Jim and Carolyn continued their active lifestyles. They golfed, played tennis, and vacationed in Italy, Belize and Israel.
The couple had recently retired – Jim was an oil and gas attorney, Carolyn a speech pathologist.
“We worked hard all our lives,” Jim says. “We weren’t about to let cancer spoil our fun.”
Ravandi instructed them to notify him if Jim’s blood counts dropped during their travels.
“I told him I’d help him access medical care wherever he and Carolyn happened to be,” the doctor says.
Trouble in South Carolina
That day came in July 2020, when Carolyn and Jim joined their children and grandchildren at the family’s vacation home on an island off the South Carolina coast.
Jim had looked forward to fishing, boating and swimming with his grandkids. Instead, he ended up spending most of his time in bed.
“I was experiencing a level of exhaustion I’d never felt before,” he calls.
Two blood transfusions at the small hospital on the island helped him regain enough strength to fly home to Houston.
Finding a stem cell donor
It was time to try something different. Jim was tired of the endless transfusions. And he worried his disease might be worsening.
“A stem cell transplant is the next step,” Ravandi said, “but you’re 73 years old, and that’s pushing the limit. You may not be approved.”
That lit a fire under Jim.
“From that moment on, I wanted the transplant as soon as possible,” he says. “I didn’t want to age out, and I didn’t want my disease to develop into leukemia.”
“He was in better shape than many men half his age,” Al-Atrash says.
A worldwide search located a 28-year-old man in Germany who was Jim’s perfect match.
“We prefer donors who are 18 to 35 years of age,” Al-Atrash says. “Research shows that cells from younger donors lead to better long-term survival for patients after transplant.”
The donor’s cells were collected in Germany and flown by medical jet to Houston. Soon they would offer Jim a chance for a cure.
Preparing for a stem cell transplant
In the hospital, Jim received two weeks of high-dose chemotherapy to wipe out the cells in his bone marrow and make room for his donor’s healthy cells.
Because this raised his risk for infection, he was not permitted to venture beyond the 8th floor stem cell unit, where a special air filtration system prevents germs from entering. Carolyn stayed by his side. The COVID-19 pandemic was at its peak. Visitors, like patients, couldn’t leave.
“I was there for the long haul,” she says.
A 50th anniversary celebration
On Jan. 26, 2021, Jim received his donor’s stem cells through a vein in his arm.
“It was just like a blood transfusion,” he says. “It was painless and took less than an hour.”
After the stem cells entered Jim’s bloodstream, they began migrating to his bone marrow and producing normal, cancer-free blood cells.
Four days after the transplant, Jim and Carolyn celebrated their 50th anniversary in the hospital.
“‘For better or for worse’ took on a whole new meaning,” Carolyn says.
Thriving after a stem cell transplant
Today, Jim’s blood counts are normal. He no longer needs transfusions, and his energy is back.
“Best of all,” he says, “I don’t have the threat of leukemia hanging over my head.”
He and Carolyn are planning another trip – this time it’s for Jim’s German donor. They’re flying him to Houston so the entire family can thank him personally.
“Carolyn and I are filled with gratitude,” Jim says. “We’re thankful for my donor, for all our friends and family who prayed for us, and for the excellent care we received at MD Anderson.”