A Nurse’s Journey From AML Diagnosis to Life-Saving Bone Marrow Transplant

When Virginia Kowalsky from Blackwell, Oklahoma, went in for back surgery in early 2022, she was focused on recovery and getting back to work as an emergency-room nurse. But that was not how things unfolded.

A week after the surgery, Virginia had some unexpected spotting. For a 65-year-old woman, spotting is abnormal and requires immediate follow-up. The biopsy results revealed that she had serous endometrial carcinoma, a rare and aggressive form of uterine cancer.

Within weeks, Virginia had a hysterectomy and started chemotherapy in July 2022. Despite the exhaustion, she continued working while undergoing treatment, determined to keep life as normal as possible. By November 2022, she had completed her final chemotherapy infusion, and a December scan brought the good news that there was no sign of disease.

“I really thought that was it,” Virginia said. “After everything — the surgeries, the chemo — I was just grateful to be clear.”

But six months later, things took a darker turn. In May 2023, after some dental work, Virginia began developing painful mouth sores that wouldn’t heal. By August, blood tests revealed dangerously low platelets, and a bone-marrow biopsy confirmed acute myeloid leukemia (AML) — a fast-growing cancer of the blood and bone marrow developed as a rare complication of her initial chemotherapy.

“It was hard to believe,” she said. “You survive one cancer, and then you hear that the treatment for it caused another one.”

Understanding Acute Myeloid Leukemia (AML)

Chemotherapy-related acute myeloid leukemia (t-AML) is a rare but serious type of blood cancer that can develop after chemotherapy or radiation therapy for another illness. These treatments can damage DNA in bone-marrow cells, leading to abnormal white blood cells that grow uncontrollably and crowd out healthy ones.

AML spreads quickly through the bloodstream. The bone marrow makes too many immature white blood cells called myeloblasts that don’t work properly, causing fatigue, frequent infections, and easy bruising or bleeding.

Therapy-related AML usually appears one to seven years after treatment and is more common in older adults. It can be harder to treat than other types and may have a lower chance of recovery.

Virginia was referred to hematologist/oncologist Dr. Taha Al-Juhaishi, M.D., assistant professor of medicine andassociate chief medical officer for Cancer Services at OU Health, for transplant evaluation. Dr. Al-Juhaishi, also a bone marrow transplant specialist, was Virginia’s best, and only chance at a cure.

“My doctor told me OU Health was the only place in the state that could do the transplant,” Virginia said. “Otherwise, I would’ve had to go out of state, maybe to Houston or the Mayo Clinic. I was so thankful I could stay close to my home and family.”

In November 2023, Virginia started a stem cell transplant treatment at OU Health Stephenson Cancer Center, a National Cancer Institute (NCI)-Designated Cancer Center and Oklahoma’s only cellular-therapy and comprehensive stem-cell program accredited by the Foundation for the Accreditation of Cellular Therapy (FACT).

What Is a Bone-Marrow Transplant?

A hematopoietic stem cell transplant (also called a stem cell transplant) gives a person new, healthy stem cells to replace the damaged ones in their marrow — the soft tissue inside bones that makes blood cells. In leukemia, the marrow stops working properly and produces abnormal cells that can’t do their job.

In an allogeneic transplant, stem cells come from a donor whose tissue closely matches the patient’s. This approach, often used for blood cancers like leukemia, can help fight cancer directly by creating a new immune response.

After pre-transplant chemotherapy in January 2024, Virginia continued treatment at OU Health while the team searched the national registry. In March 2024, a matched donor was found.

The Donor Who Didn’t Hesitate

More than a thousand miles away in northern Alabama, Dylon Lange was working and living his life when he received an unexpected phone call — one that would save a stranger’s life.

Over a decade earlier, at 19, Dylon and a group of college friends had signed up for the national marrow registry after seeing an ad on campus.

“We thought it would be a cool idea,” he said. “The odds of being picked as a donor were so slim, but if we ever got the chance, we’d do it.”

He didn’t think about it again for 12 years, when a letter arrived saying he was a potential match for a patient who needed a bone marrow transplant urgently.

“I never second-guessed doing it,” Dylon said. “My only worry was — what if it didn’t work? What if I tried, but it still wasn’t enough?”

After additional testing, Dylon learned he was the best match. The registry arranged for him and his wife Samantha to fly from Alabama to Houston for the donation. For a week before the procedure, he received daily injections to stimulate his body to overproduce stem cells. The process that left him aching and exhausted.

“I felt like I’d been hit by a truck,” he said. “It was worse than any flu or COVID I’ve ever had.”

Then, the night before their flight from Atlanta, severe weather caused cancellations, forcing Dylon and Samantha to drive through the night to catch another flight from Nashville.

“It was chaos,” he said. “But I knew I had to get there. Someone was waiting.”

The next morning, nurses connected him to a machine that separated his stem cells from his blood — similar to plasma donation but lasting nearly five hours.

“It wasn’t painful,” he said, “just exhausting.”

When it was over, he returned to the hotel and slept for 12 hours before flying home the next day.

It took several weeks for Dylon to feel back to normal.

“But it was nothing compared to what Virginia had gone through,” he said. “If it would help her, or anyone else — I’d 100% do it again.”

Within 72 hours of Dylon’s donation, his stem cells arrived in Oklahoma City. On May 7, 2024, Virginia received the cells that would rebuild her immune system and save her life.

“When I later heard she was doing well, it was like a weight lifted,” Dylon said. “Just knowing she was okay made everything worth it.”

Life After Transplant: Maintenance, Monitoring and Meaning

After a bone marrow transplant using donor cells, doctors look for chimerism (how much of the marrow is made up of donor cells versus the patient’s original cells). When tests show full donor chimerism, it means the donor’s healthy cells have taken over. These cells don’t just make new blood; they also help protect the body by recognizing and attacking any leftover leukemia cells.

Virginia returned to Stephenson Cancer Center for maintenance chemotherapy every few weeks, completing 12 rounds, and underwent serial bone-marrow biopsies to monitor for relapse. Seventeen months after transplant, she continues to rebuild stamina. She can handle yardwork and household tasks but isn’t ready for 12-hour ER shifts.

“I’m here, and I’m getting stronger,” she said. “I’m thankful to Dylon and Dr. Al-Juhaishi every day.”

To date, all biopsies have shown no leukemia with 100% donor cells. She remains in remission and in close follow-up with the OU Health transplant team.

A Doctor’s Devotion

For Dr. Al-Juhaishi, caring for patients like Virginia is both scientific and deeply human.

“In oncology, the science is high stakes but so is the humanity,” he said. “These are people walking through the hardest chapters of their lives. My job is to help them make decisions that make sense for them and their families, and to guide, to be honest, and to give hope.”

He chose oncology, he explained, because it combines discovery with purpose.

“The science is constantly evolving, but it’s also about empathy,” he said. “You can’t treat cancer without remembering that every decision affects a person and a family. That’s what keeps me grounded.”

Dr. Al-Juhaishi believes Oklahomans deserve access to the same expert care available anywhere in the country, without having to leave home.

“Every person with leukemia deserves a second opinion at a center that treats a high volume of cases,” he said. “At OU Health, we see more blood-cancer patients than any other hospital in the state. We have the expertise, technology, and the clinical trials. For many of these diseases, transplant is curative, and we can do that here.”

Bone Marrow Transplant at OU Health

At Stephenson Cancer Center, breakthroughs in cellular therapy and compassionate, world-class care give patients like Virginia hope, and life, right here in Oklahoma.