Butcher fighting transplant setback

By Jeff Richardson


Published July 23, 2006

A “serious complication” in Susan Butcher’s fight against leukemia has led the famed Iditarod musher to pursue an experimental therapy at a Seattle hospital.

Dr. Jan. Abkowitz, Butcher’s doctor for the past four years at University of Washington Medical Center, said a bone marrow transplant performed on May 16 has been successful in clearing Butcher’s system of cancer, and that all of her blood cells are now being created by the donor cells. But her body’s response to the transplant itself is threatening Butcher.

The latest complication is Graft Versus Host Disease, which emerges in more than half of marrow transplant patients. The disease causes the donor cells to perceive Butcher’s own cells as invaders, causing the immune system to fight them. The condition is making Butcher’s body attack its own digestive system, resulting in symptoms that include abdominal pain.

The condition isn’t deteriorating, Abkowitz said, but various treatments haven’t improved it. In its most serious form, GVHD can be life-threatening.

“She’s been kind of holding her own and not improving,” Abkowitz said. “Rather than getting worse, she’s not getting better.”

Doctors have been trying to resolve the problem with various therapies for the past three weeks, but three previous approaches didn’t have any effect. After those efforts failed, Butcher began receiving an experimental new therapy on Wednesday. According to Abkowitz, Butcher is among just a handful of patients who are undergoing that treatment for GVHD.

Although Butcher, 51, had been recovering well since undergoing her transplant operation, Abkowitz said such setbacks aren’t unusual. Patients like Butcher are required to remain in Seattle after their transplants because problems frequently occur.

Still, the severity of the reaction has Abkowitz describing it as “a serious complication.”

“The timing is expected. We just hoped it wouldn’t happen or it would be milder,” she said.

Butcher has been joined in Seattle by her husband and fellow musher, David Monson, and their two daughters. Monson’s recent online updates have been bleak, as he describes Butcher growing groggy and weak from the medication and bed rest. Because of muscle atrophy, Butcher must have help moving her legs in some positions.

“When I see the effort she puts into these small movements it reminds me why she won the Iditarod,” Monson wrote. “Her determination to overcome adversity and pain.”

The new treatment, meanwhile, is largely a mystery. The outcome and the side effects it may involve are still unknown.

“Unlike the initial treatment for cancer, the chemo and the radiation, there is no certain pattern or map for where this will lead,” Monson wrote. “Even the (doctors) wait and watch to see where they are going. The days seem longer because of the uncertainty.”

In Alaska, where Butcher remains an icon, the effect of her illness has been profound. She helped lead a drive to boost Alaska’s participation in the National Bone Marrow registry last December, and more than 1,000 people in Fairbanks and Anchorage responded.

Chas St. George, an Iditarod spokesman, said the mushing community has been tracking the recent news closely and doing what it can to support the family. When Monson’s bicycle was stolen from outside the hospital last Wednesday, a volunteer network arranged for REI to donate a new bicycle within a day.

St. George said the affection for Butcher and Monson goes far beyond their mushing accomplishments.

“People know her as a four-time Iditarod champ, but that doesn’t even begin to scratch the surface,” St. George said. “These are special people.”

Jeff Richardson may be reached at jrichardson@newsminer.com or 459-7510.