Man fights rare cancer with twin’s identical stem cells

A transplant of stem cells from Blair Johanson, left, helps his twin brother, Bruce, fight cancer.
Credit:	Courtesy Bruce Johanson

A transplant of stem cells from Blair Johanson, left, helps his twin brother, Bruce, fight cancer. Credit: Courtesy Bruce Johanson

Bruce and Blair Johanson always knew that they were identical twins, even though a medical intern told their mother when they were born that they were fraternal. Fortunately for Bruce, the intern was wrong. Because they are identical, Blair was able to help save Bruce’s life by donating stem cells to help him fight cancer.

This past spring, a bad upper respiratory infection sent Bruce, 60, to the doctor. A blood test found that his white blood cell counts were off. In May, after more tests, Bruce was diagnosed with mantle cell lymphoma, a rare form of cancer representing only about 6% of all new cases of non-Hodgkin’s lymphoma in the United States, according to the Leukemia & Lymphoma Society.

After a few months of chemotherapy at home in Arkansas, Bruce was referred to Dr. Julie Vose, chief of the Oncology and Hematology Division in the Department of Internal Medicine at University of Nebraska Medical Center and an expert in the treatment of lymphoma.

During Bruce’s first visit with Vose, he mentioned that he had a twin brother. This was a very good thing, she said.

“Normally, we would self-transplant,” Vose said, meaning doctors would use Bruce’s own stem cells to help replenish his bone marrow after chemotherapy and hope they didn’t contain the cancer cells. But if Bruce had an identical twin, his brother would be a perfect match.

“Nobody on earth has identical DNA,” Vose explained, “except identical twins.”

This meant the stem cells Blair gave would be the same as Bruce’s own but with one important difference: no cancer.

“We know there are no lymphoma cells hiding in there,” Vose said.

But were Bruce and Blair identical twins? Their mother still heard that intern’s voice in her head, telling her they weren’t.

The two men are best friends and have always been close. They shared a bedroom growing up and even through college, Bruce said. When they got married, they moved into the same apartment complex. Even after Blair moved away, the brothers ended up buying very similar-looking cars and continued to dress the same without knowing. In the mid-1990s, Blair moved back to Fayetteville, Arkansas, and joined his brother in running their own management consulting firm.

“If you looked at us, you would go, ‘they’ve got to be identical,’ ” Bruce said.

But the intern had told their mother that the boys had been delivered in separate amniotic sacs and had to be fraternal, Bruce explained. If that was the case, the transplant wouldn’t work.

A DNA test was the only thing that could prove that the brothers were identical and clear Blair to donate his stem cells.

When the results came in, the twins hosted a reveal party at their mother’s house. They put two blue jelly beans under the frosting of two cupcakes. Their mother had the answer: They were identical.

“She was the only one surprised,” Blair said.

On October 17, Blair and his wife traveled to Nebraska to begin the blood tests and shots to prep him — and his stem cells — for donation. When the time came, Blair said, it took about three hours to get all the stem cells doctors needed.

It wasn’t the most fun experience, Blair said, but donation wasn’t so bad. “Giving stem cells is not a tough process,” he said.

On Wednesday morning, Bruce sat in an outpatient center at Nebraska Medicine in Omaha while a catheter pumped in Blair’s stem cells. Hundreds of miles away in Arkansas, Blair joked with his twin on a video call.

“It’s just amazing what can be done now and how far medicine has come along,” Blair said. “Bruce is tough, and he has a lot of people praying for him and a lot of people supporting him.”

Bruce is now in a hotel near the hospital, his doctor said, getting blood infusions and taking antibiotics to prevent infections while his white blood cells replenish. He goes to the hospital for checkups once or twice a day and should be able to go home in a few weeks. Three months after treatment, he’ll be re-evaluated to see whether the cancer is in remission.

“Everything is positive so far,” Vose said, thanks to the identical stem cells.

“It is a gift,” Bruce said. “He was more than willing to do this for me, and I’d be more than willing to do it for him.”


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