More than 2,600 people lined up in November at a Farmingville bone-marrow drive to become a potential donor for 6-year-old leukemia patient Julianna Buttner.
But there was no match.
Now it's up to Julianna's twin sister, Jessica.
Jessica will donate bone marrow in the effort to beat back Julianna's acute lymphocytic leukemia, which is also known as ALL. Her disease returned in September after three years in remission. So far, it has defied chemotherapy.
"We have very limited time now, and time is of the essence," Michael Buttner, the twins' father said Thursday. "She has to get into treatment for the best outcome. We were hoping there would have been a match in the drive, but we just found out there weren't any, so we had to move forward with Plan B."
Until now, Jessica had not been considered the ideal donor for Julianna. Doctors were uncertain that Jessica's bone marrow would combat ALL because it is genetically identical to Julianna's, which is being threatened by the disease. Jessica also has diabetes.
A bone marrow transplant can be performed one of two ways, said Dr. Robert Parker, director of pediatric hematology and oncology at Stony Brook University Medical Center and associate director of the cancer center there.
Marrow can be collected from the pelvis and refrigerated until infusion. Or, medications can be given to the donor to recruit stem cells into the blood stream from which they can be withdrawn.
Julianna had been treated at Stony Brook throughout her illness, but pediatric bone marrow transplants are not performed at Stony Brook. Starting in a few weeks, she'll undergo the procedure at Memorial Sloan-Kettering Cancer Center in Manhattan. The treatment consists of several steps and takes up to three months.
It includes a weeklong conditioning procedure during which Julianna receives radiation and chemotherapy to destroy leukemia cells - and her immune system. Two days afterward, she will undergo an hourlong infusion in which she receives her sister's cells. Weeks of monitoring follow.
Michael Buttner said the family will live in a Ronald McDonald House while doctors determine how their daughter is progressing.
"Julianna will receive Jessica's immune system," in the transplant, Parker said. "Does that that mean she will develop Type 1 diabetes? There's no way to predict that upfront because we don't fully understand all of the issues determining the development of an autoimmune disorder."
Katharina Harf, founder of DKMS Americas in Manhattan, which sponsored the Farmingville donor drive in November, said people who volunteered their cell-samples to Julianna's cause might still help others. Their cellular information is being added to the donor registry, which is used to find matches for other patients in need of bone marrow transplants.
Months spent coping with a sick child have strained the Buttners' finances. Michael Buttner owns a small home improvement company, but he has virtually stopped working since the resurgence of Julianna's leukemia.
Now he and he and his wife, Lynda, are bracing for the next phase in the effort to help Julianna. But they have extra help now.
"Jessica has been watching her sister go through all of this," Buttner said. "Now it's her chance to be the star."
The Buttner family has events and a special fund to help pay its medical bills:
On Jan. 23, all proceeds from the Subway restaurant at 400 Horseblock Rd. in Farmingville, will be donated to the Hope for Julianna Fund.
A fundraiser is scheduled from 4 to 8 p.m. April 11, at Mulcahy's Pub and Music Hall, 1702 Middle Country Rd., Centereach.
Donations to the Hope for Julianna Fund can be sent to: P.O. Box 143, Farmingville, NY 11738.
To become a bone marrow donor, you can join the Be the Match Registry at a donor registry drive or online at bethematch.org. People must be between the ages of 18 and 60 and fill out a health history form.
If joining in person, your cheeks will be swabbed for cells. If joining online, you will be sent a swabbing kit in the mail. The swabs will then be analyzed for their type and your name placed on the registry.