Stem Cell Transplant Recipient Forms Powerful Bond with Doctor and Donor  

“The world needs more Dr. Soiffers – and more Nicoles.” 

Such is the wisdom of Judy Mangione, 80, who credits these two individuals for the fulfilling life she is enjoying with her husband, Bob, and their combined six children and 10 grandchildren. 

Robert Soiffer, MD, treated Mangione with the January 2022 stem cell transplant that stopped the rapid progression of her chronic myelomonocytic leukemia (CMML), a rare, incurable bone marrow cancer that usually proves fatal in two to five years. Nicole Karem was the then-anonymous young law school student who proved to be a match – the only match – that Soiffer and his team in the Adult Stem Cell Transplant Program at Dana-Farber could find for Mangione in the international stem cell donor database.  

“There is always a risk in getting a transplant, but as a professor of mathematics education I knew the odds were not on my side if I didn’t get one,” Mangione says with a smile.   

To solve the problem, though, Mangione needed a donor as part of the equation. 

What resulted, she attests, is proof that goodness surrounds us even in the darkest times. While Soiffer provided the expertise, he could not have used it to save Mangione without Karem’s selfless gesture.  

“That’s what amazed me most, that Nicole would spend a day at the hospital giving stem cells to a perfect stranger,” says Mangione. “Then I met her, and I understood.” 

Parallel Paths 

The road that eventually brought these two women together began five years earlier.  

Karem, then a senior at the University of Kentucky, was walking across campus one fall day in 2018 when she passed a table sponsored by the NMDP. Raised in a family where charity was expected rather than just encouraged, she provided a cheek swab and her name to the registry of those willing to donate stem cells sometime in the future. 

 “My parents raised me and my siblings to be very socially engaged and conscious of our impact on the world around us,” says Karem. “I always get asked why I would sign up, but my thought process is more like, why wouldn’t I?” 

Meanwhile, nearly 1,000 miles away, Mangione was newly married and taking a year’s research leave from her faculty position at St. John’s University. She and Bob – who she had met at St. John’s, where he was provost – had just purchased a vacation home in Marshfield, Mass., near her family. She was conducting research at area schools, while Bob traveled back and forth to St. John’s New York City campus. 

When Mangione began feeling exhausted, and visited her general practitioner, she learned that her blood stem cells had slowly been depleting for years, limiting her body’s ability to produce healthy white blood cells needed to fight infection and disease. A New York hematologist suspected she might have immune thrombocytopenia (ITP), an autoimmune disorder that can be a precursor to CMML. Wanting a more expert opinion closer to her new home, Mangione met with Rajitha Sunkara, MD, then at Dana-Farber Brigham Cancer Center at South Shore Health. 

“Dr. Sunkara agreed it seemed like ITP, but wanted to do a bone marrow biopsy to rule out cancer,” recalls Mangione. “When the results came back, I think she was as shocked as we were that it was leukemia.” 

Sunkara immediately referred Mangione to Eric S. Winer, MD, a CMML specialist in the Adult Leukemia Program on Dana-Farber’s Boston campus. Mangione retired, she and Bob made their move to Massachusetts permanent, and for the next two years Winer provided supportive care, monitored her platelet levels, and served as a sounding board for questions and concerns. 

“Eventually, my platelet count started going down again, and Dr. Winer said, ‘It’s time, Judy,’” Mangione says. “I needed a stem cell transplant.” 

A few months later, now in law school at George Washington University, Karem got a phone call from the NMDP. Her stem cells were needed.  

“All I knew was that the recipient was a woman in her 70s,” says Karem. “I had my blood drawn, answered a bunch of questions, and then in early January 2022 I missed my second day of classes of my spring semester and went to Georgetown University Hospital to make my donation. It took eight hours, which I passed by watching a movie, listening to some podcasts, and reading. I was back at school the next day.” 

By that point the stem cells she donated had already been shipped to Boston – and were transfused by Soiffer and his team into Mangione’s bloodstream on Jan. 12, 2022.  

Coming Together 

A year passed, much of which Mangione spent in and out of the hospital as her new immune system strengthened. Soiffer visited each day she was inpatient to help keep her spirits up during the challenging recovery.  

On the first anniversary of her transplant, Mangione and her husband held a gratitude celebration for around 50 friends and family members — thanking each of them by name for their care and support over the previous year while also acknowledging her Dana-Farber care team. The event ended with a shared moment of thanks for her still-anonymous donor. That same day, on the St. John’s campus, a mass was offered in her donor’s honor. 

Shortly thereafter, with the required one year waiting period complete, Mangione wrote a thank-you note to Karem, who wrote back. Once Karem consented to revealing her identity, the pair quickly bonded over texts and phone calls. And when Karem surprised Mangione in March 2023 by asking her and Bob to visit during her spring break, they didn’t hesitate. 

“We got the OK from Dr. Soiffer, packed the car with food and disinfectants, and drove straight to Washington,” Bob recalls. “I was nervous, because Judy was still recovering, but I let her do all the driving. I knew how important it was for her. She wanted Nicole to meet her as a strong woman.” 

The meeting was everything Mangione had hoped for. 

“The minute she walked into the restaurant, I knew who she was,” recalls Mangione. “Bob kept saying, ‘Now I know what you were like as a younger person.’ There was so much commonality between us, and everything about her spirit and values resonated with me. It was just unbelievably beautiful.” 

Karem agrees. 

“It was like instantly gaining another aunt,” she says. 

The two have stayed in touch ever since, with Karem taking several trips to Massachusetts to meet Mangione’s family and friends, and Mangione zooming with Karem’s parents back in Kentucky. Judy and Bob hope Karem’s kindness and generosity will be an example for their grandchildren. 

Done with school, Karem is now a lawyer working with the federal government. Mangione, meanwhile, is enjoying retirement and getting regular checkups with Soiffer. So far, everything looks good – and she feels great. 

During one of Karem’s visits, Mangione took her to meet Soiffer. It was a moving experience for all of them. 

“There exists a special bond between volunteer stem cell donors and their recipients,” says Soiffer. “For the patient, the donor offers what may be the only opportunity for cure of their disease, while for donors, giving stem cells affords what for most ordinary people is a unique opportunity to save a human life.” 

And bring two lives together. 

About the Medical Reviewer

Dr. Soiffer graduated from New York University School of Medicine in 1983, and trained in internal medicine at Brigham and Women's Hospital, where he also was chief medical resident. He joined DFCI in 1988, after completing a medical oncology fellowship. He is currently chief of the Division of Hematologic Malignancies and codirector of the Adult Stem Cell Transplantation Program. Dr. Soiffer is chairman of the Center for International Blood and Marrow Transplant Research advisory committee and has served as vice president (2006), president (2007), and immediate past president (2008) of the American Society of Blood and Marrow Transplantation.