Leukemia Victim Gets Second Shot at Life, Wedding Photos

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Melinda Muniz's first wedding photos were taken in her hospital bed as she was fighting a deadly leukemia, 50 pounds thinner, pale and literally at death's door.

A priest had agreed to come to her bedside in June and marry the 35-year-old social worker to her decade-long boyfriend, the father of two of her four youngest children.

But in October, thanks to pioneering doctors at Thomas Jefferson's Kimmel Cancer Center in Philadelphia, where she received chemotherapy and a half-match bone marrow transplant, Muniz was given a second chance at life.

And last week, feeling strong and looking healthier, she was given a second shot for her wedding photos -- in a white gown and under much healthier conditions.

Wedding photographer Jerry Tomko, himself a stomach cancer survivor, surprised the couple with a floral bouquet and a limousine and took photos at historic sites in around the City of Brotherly Love.

This time, she had a flowing white gown, a big smile, and was well on the road to recovery.

"No wig, though," said now-cancer-free Muniz, as her husband Christopher Jones added, "She's beautiful just the way she is."

Tomko said he was so grateful to Thomas Jefferson doctors for helping him "beat" his cancer that he asked them to help him find a way he could use his skills as a photographer to give back.

"I wanted to do something for a cancer patient or survivor, someone whose family or parents couldn't really afford really good wedding photos because of financial hardship or disease," he said.

Muniz said she still doesn't know how to thank him. "It's so amazing there are people out there in the world, willing to do things like that," she said.

Her ordeal began last spring, when she began to feel tired, but brushed it off.

"I am the mother of four and always working, washing and cooking," she said. "There was a lot going on."

But even after a good night's sleep, she was waking exhausted. A tooth infection then led to dizziness and eventually a fever, so she went to the emergency room.

"They took some blood and said, 'Wow, I can't believe you are still standing,'" she said.

By May 27, she had been transferred to Thomas Jefferson Hospital where she was diagnosed with acute myelogenous leukemia or AML.

She and Jones, a maintenance worker, had been engaged since 2009, but hadn't yet set a date.

"I think he took it harder than me," she said.

Jones quit night school to look after the children, as she began round-the-clock chemotherapy.

AML is the most common leukemia among older adults, but is relatively rare in a young women like Muniz, according to Dr. Margaret Kasner, assistant professor of the department of medical oncology at Thomas Jefferson, who treated Muniz.

About 11,000 new cases are diagnosed each year and the overall five-year survival rate in adults is 30 percent.

"We don't know what causes it," Kasner said. "Exposure to radiation, prior chemotherapy for those treated for breast cancer are at high risk. But for most people, it's spontaneous and there is no familiar link."

With such a dire diagnosis, the couple decided to marry right away, the day after her chemotherapy began.

"I felt so horrible, just off chemo and so emotional," said Muniz. "I said absolutely no pictures, but my sister said, 'You have to.'"

Muniz said she felt too sick to go to the chapel, so the nurses decorated the room and bought a cake. Jones bought rings and they were married.

In the end, the photos were grim.

"I was really pale with bags under my eyes. I was fragile and had lost a lot of weight -- even my mother had said, 'Honey, you're not looking so good,'" she said.

But there was hope to come, medically and otherwise.

Doctors wanted to get her cancer into remission so they could give her a life-saving bone marrow transplant.

She was typed for her human leukocyte antigen or HLA, and none of her siblings were a complete match for a traditional transplant.

Half-Match Transplants Give 'Mind-Blowing' Results

In any given family, 25 percent of siblings have an identical match, 50 percent share the same HLA with their mothers and 50 percent with their fathers. In an average-sized family, a patient has a 1 in 3 chance of a complete match.

"That means two-thirds of individuals are disenfranchised," said Dr. Neal Flomenberg, chair of the department of medical oncology at Thomas Jefferson Hospital and founder of the blood and marrow transplant program.

Now, in a haplo or half-match transplant, siblings and parents who have one, but not both, of the same gene types can be donors.

The procedure doubles the number of potential donors for cancer patients, particularly among hard to match minorities like Muniz, according to Flomenberg.

The procedure is not new, but its timing was perfected at Thomas Jefferson to reduce transplant toxicity.

Because the immune system is weakened by chemotherapy, cancer patients can die during the transplant process -- when infections set in or due to host-graft disease, which damages the lungs or liver.

The half-match procedure, the only one in the region, reduces toxicity and about 80 percent of the patients go into cancer remission.

Patients receive their transplant in two steps. First, after radiation, they are given a specified dose of infection-fighting T cells from their half-matched family donor. Next, they receive the drug cyclophosphamide to help the newly infused donor T cells to be better tolerated in the patient's body.

In the second step, patients receive a dose of their donors' stem cells to help their blood counts return to normal and further strengthen their new immune system.

"Outcomes have exceeded our wildest expectations at this point," he said. "The success rate is mind-blowing."

"The immune system recovers promptly and they may develop some mild host-graft disease, but it's easily managed," said Flomenberg.

In Muniz's case, doctors selected her 34-year-old sister Anna, a twin, as her half-match donor. Even though she was the smallest of the three siblings, her T-cells were stronger, according to Muniz.

"She was my little angel," she said.

Meanwhile, Tomko, who owns his own photography studio, had waged his own medical battle at Thomas Jefferson. The 57-year-old had been diagnosed in 2007 with a virulent form of stomach cancer.

"I was doing 52 weddings that year," he said. "On July 30, they told me I had cancer and on Aug. 15, I was on the operating table and they took 80 percent of my stomach out."

Tomko endured three and a half months of chemotherapy and 25 radiation treatments, but within four to six weeks after his surgery, he was back to his 31-year career as a wedding photographer.

"It was the brides who kept me going," he said. "Personally, I didn't feel I could let them down."

At first, the hospital didn't seem to know how to use his talent, but last year at a Philadelphia Eagles football game, Tomko met a woman who worked for an oncologist at Thomas Jefferson and said, "We have the perfect person."

When he finally met Muniz, she looked at Tomko and said, "There's no charge? This is free?"

Today, Muniz shows no signs of leukemia.

"I feel great and I am starting to get my energy back," she said. "I am eating better, have gained weight and am definitely stronger."

But she gets teary when she talks about others with the disease.

"I see a lot of patients are on the waiting list now to get bone marrow because they don't have a match," she said. "That's very emotional for me. I had a chance."

On Feb. 8, Tomko escorted Muniz and Jones around the city for a series of stunning photos. Even a lightly falling snow didn't dampen their spirits.

"Words can't explain, how I feel about my wedding pictures," she said afterwards. "Jerry is great. I was nervous at first, but he made me feel like I knew him forever and he will always have a special place in our heart. ... I felt like we were getting married again."

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