She was on a tropical vacation when she received a text message: You need to come home to save a life

Rachel Sophia Stewart was on vacation in Puerto Rico in early December when her phone began blowing up with a number she didn’t recognize.

“Why are they calling me so much?” she asked her boyfriend, Gaurav Jadhav.

Then came a text that implored her to call back immediately. It was from Be The Match, the National Marrow Donor Program.

“I had this feeling in my gut,” said Stewart, 28, who lives in South Philadelphia.

Stewart, a documentary film editor who works for History Making Productions, was told she was a potential match as a bone-marrow donor for a 49-year-old man in need of a transplant. She was asked to contact Be The Match immediately upon her return home.

Eighteen months earlier, Stewart’s older sister, Kate Stewart Cremer, a mother of three young boys, had signed up online to become a bone-marrow donor. That prompted Stewart to send away for the Be The Match donation kit.

“I’ve always donated blood," she said. “Our high school had a program for it, and I’m pretty committed to doing that because here is a huge need.”

The kit arrived in the mail with a questionnaire and instructions on how to use the enclosed cotton swabs to collect DNA from inside her mouth. Stewart, who was sure she would never get called, completed the task in about 10 minutes, and used the kit’s prepaid envelope to mail off the swabs to Be The Match. And then she forgot about it.

Bone marrow transplants are used to help treat patients with cancers like leukemia and lymphoma, and other life-threatening diseases. About 70% of patients do not have a family member who matches.

The Be The Match registry has more than 20 million members and 295,000 umbilical cord blood units that can be used for donations. In 2018, the organization helped with nearly 6,200 blood stem-cell transplants, contributing to about 92,000 overall since 1987. The organization provides support and financial assistance to patients and is conducting more than 200 research studies to improve patient outcomes.

When she got the call to donate, said Stewart, “right away it felt overwhelming and a little scary." But her boyfriend, Jadhav, an internal medicine physician, was able to answer her questions and ease her concerns about what the donation procedure would entail.

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Once Stewart was back home, Be The Match assigned her a “concierge” to help navigate the donation process, which included health screenings and al blood test to confirm that she was, indeed, a good match for her potential recipient. The concierge also had frank discussions with Stewart about how the donation was voluntary and that Stewart could back out at any time, for any reason.

While reviewing the consent form for the procedure, Stewart learned that if she backed out at the last minute, the recipient would likely die: Recipients undergo treatments that destroy cancer cells and unhealthy bone marrow and leaves them vulnerable to life-threatening infections.

“That’s a powerful thing to read in a statement,” she said.

At first, it didn’t hit Stewart that her donation would help save someone’s life — the potential recipient, unknown to her, was too abstract. But then she thought of her father, a nurse in Reading, and how, years ago, when he was 48, she was just 8. She let herself feel what it would have been like to lose him back then.

“I would want someone to do that" — donate marrow — "for my dad,” she said.

It wasn’t until Feb. 7 that Be The Match contacted Stewart with the results of all the screening tests.

“You are weirdly a perfect candidate,” she was told. The proof: When the human leukocyte antigen (HLA) typing is done to match patients with unrelated donors, an 8 out of 10 score is considered good. Stewart was a 10 out of 10 on the genetic match.

“Everything for me and that guy lines up,” she said. "I don’t know who he is, but genetically we are well-attuned.”

Their blood types were different, though, so when he received her marrow, his would change to her type: O positive, she learned.

To prepare for the donation, Stewart received five shots of filgrastim, a medication that increases the number of blood-forming cells, over as many days, according to Be The Match. She might experience side effects from the shots, such as some hair loss and bone pain.

There were also more health questions to answer, as well as urine testing and a three-hour physical to undergo.

The first injection occurred March 13 at the Cancer Treatment Centers of America on East Wyoming Street in the Crescentville section of Philadelphia. The last occurred on the actual donation day: March 17, St. Patrick’s Day.

“I treated myself to a cinnamon muffin and then went into work,” Stewart said about her first shot.

She soon began to feel the effects as her bones began to overproduce marrow.

“By day three, it was really starting to wear me down,” Stewart said. Her hips and ribs throbbed. She described it as feeling the way fictional character Harry Potter must have when he had to regrow all the bones in his arm after breaking them in a Quidditch match.

“I had to keep telling myself it’s not worse than what my guy is going through,” Stewart said.

Stewart arrived at the hospital for the donation at 7 a.m., accompanied by Jadhav.

Nurses inserted two intravenous lines, one in each arm, and added a blood-pressure cuff to one leg. She was essentially tethered to a bed for the duration of the process and was not able to bend her arms.

The staff made her feel like a star, she said. They checked into wish her well, hand-fed her snacks and apple juice, and even gave her a cake as a thank-you for her donation.

One visitor — a nurse who had received a bone-marrow donation to cure her leukemia — made a special impact.

“Here was a real face, this person telling me she is alive because of this type of donation,” Stewart said.

Stewart’s recovery from the procedure has been uneventful. Since her resistance to infection would be low for a few days, she was told to stay inside after the donation (within days, of course, the whole city was being advised to stay inside, because of the coronavirus).

A year from now, Be The Match will allow Stewart and the recipient to make contact if each agrees to it. But Stewart said she is not expecting anything — not even a thank-you from the recipient. She said she doesn’t need it.

“I would do it again tomorrow for that guy," she said emphatically, “and I don’t even know his name.”