just shy of the 30 weeks she was hoping to reach. Despite weighing only 2 pounds and 13 ounces, the baby was fine and placed in the neonatal intensive care unit at Monmouth Medical Center. A week later, Holloway-Davis came to, not even remembering she was pregnant until she felt the incision in her pelvic area. Knowing that Arya was in good hands and her husband was there every day playing gospel music and reading to both mother and baby, Holloway-Davis knew she would be okay. She finally learned the origins of HTLV-1 from her doctor, and they talked about next steps: chemotherapy and a bone marrow transplant from another donor (allogeneic) to treat the lymphoma that developed. “At that point, I didn’t care about where it came from. I just wanted to know what to do to get rid of it,” recalls HollowayDavis. She was soon released and underwent six cycles of chemotherapy and had her marrow tested for a transplant. Luckily, she was a candidate. “I thought ‘good, this is over.’” But it was only the beginning. The task was on to find a match for the transplant and the center that would manage this unique procedure and post care. Given a recommendation of a center in northern New Jersey, one in Manhattan or Rutgers Cancer Institute of New Jersey in the central part of the state, the choice was easy. lenging,” shares transplant coordinator Jackie Manago, RN, BSN, BMTCN as a number of donor genetic features need to be as identical as possible. Manago also points out that “identifying a match for those of Caribbean descent can be problematic in part as there is a great genetic heterogeneity spread amongst a relatively small population.” “They were very honest with me,” Holloway-Davis recalls. “They made no promises about finding a match.” But in two weeks, an acceptable candidate was found. Meeting a Mensch “Mrs. Holloway-Davis’ case is unique to say the least,” notes Roger Strair, MD, PhD (above, center), with Mary Kate McGrath, MSN, RN, APN-C, OCN, BMTCN (above, left) and Jackie Manago, RN, BSN, BMTCN (above, right). All are members of the Blood and Marrow Transplant Program team that cared for Sandrine Holloway-Davis. H er doctor told her about Roger Strair, MD, PhD, chief of the Division of Blood Disorders at Rutgers Cancer Institute, and the expertise of the Hematologic Malignancies Program and Blood and Marrow Transplant Program teams that work in concert with one another at Rutgers Cancer Institute and Robert Wood Johnson University Hospital. “He told me Dr. Strair is a ‘mensch.’ I never heard that word before,” Holloway-Davis shares. But after meeting Dr. Strair in July 2013, she quickly learned how that endearing term exactly described this consummate professional and all around ‘good guy.’ “Mrs. Holloway-Davis’ case is unique to say the least,” notes Strair, who is also a professor of medicine at Rutgers Robert Wood Johnson Medical School. “When she arrived at Rutgers Cancer Institute, she presented with a lymphoma that is associated with the HTLV-1 virus. Only a small percentage of patients infected with the virus ever develop lymphoma. Over the 20 plus years I have been at Rutgers Cancer Institute, our team has managed about 20 cases of HTLV-1 associated lymphoma.” As with any bone marrow transplant “finding a match can be chal- The Big Blast S till fatigued from her initial chemotherapy regimen, her immune system was at risk. “I remember the doctors telling me that I needed to be careful. I couldn’t receive flowers – couldn’t change my daughter’s diaper. I thought ‘What kind of mother am I going to be if I can’t even change my child’s diaper?’” But Holloway-Davis didn’t let any negativity creep in. Her family stepped in to help and she concentrated on getting well. Next was the transplant chemotherapy – “the big blast,” as she calls it – to rid the body of any remaining cancer cells and prepare the body to receive the donated marrow. The self-proclaimed “island girl” feeling “blessed and ready to fight” came upon part of the process that presented a challenge. “During the orientation I was told I could not be in the direct sun (following the transplant) – that hit me. Losing my hair? Didn’t matter. Graft-versus-host disease? Didn’t P HOTO By: DeB B I e VOGeL Summer 2017 I Cancer Connection I 11