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A screen grab from The Mixed Photography Project's Instagram account shows a portrait of Lara (bottom right), and other mixed-race people living in London. The photography project is part of the #Match4Lara campaign, encouraging mixed-race people to become donors. (@the_mixed_project)

Help wanted

One woman’s cancer diagnosis spotlights an escalating treatment problem

By Alice Robb on January 24, 2016

As a biracial woman, 24-year-old Lara Casalotti is part of a fast-growing global phenomenon. But as a leukemia patient, she’s a member of one of the hardest to treat populations. Stem cell registries have not kept pace with changing demographics — and with Thai and Italian heritage, Casalotti’s chances of finding a bone marrow donor may be slim.

Casalotti, a student of global migration at University College London, noticed that she was getting out of breath on short runs this winter, but didn’t think much of it. An avid volunteer, she flew to Thailand over Christmas break to help a professor research domestic migration. It was there that she was diagnosed with acute myeloid leukemia, and was told that she had until April to find a genetically similar bone marrow donor. When her family learned that none of them could provide a match, they launched an international campaign to find one.

Only about 30 percent of leukemia patients find a match within their own family. The rest must turn to public registries like Be the Match in the U.S. or Anthony Nolan in the U.K. — and these registries are overwhelmingly white. Nearly 7.6 million of the 12.5 million potential donors on the Be the Match registry are Caucasian — meaning a white patient has a 97 percent chance of finding a match. The likelihood drops to 72 to 88 percent for Asians, and again to 66 to 76 percent for black patients. Mixed race patients face the longest odds of all.

“Everybody has a unique identifying factor,” Carol Gillespie, executive director of the Asian American Donor Program, explained. “When you have a mixed-race person, it’s extremely difficult to find a donor for them.” They tend to have a more complex blood type, and there are practical issues, too. The potential pool of donors is smaller, and recruitment can be difficult. An Ashkenazi patient who needs a match can hold a drive at a synagogue, but mixed-race people are more dispersed. “There’s Chinatown and there’s Japan-town, but there’s no mixed-race-town,” Gillespie said. (Her organization recruits at corporations, service organizations and college campuses.) Another problem is that the multiethnic population skews young: in the U.S., almost half of multiracial Americans are below the age of 18—the minimum age for stem cell donation.

This problem, in particular, has galvanized support. In 2010, the search for a match for leukemia patient Devan Tatlow, a part-Indian, part-Caucasian four-year-old, was covered by CBS and Time, and attracted attention on Twitter from Kim Kardashian and Buzz Aldrin. In the past couple of years, there have been stories on Sophia Trujillo, a six-year-old Illinois girl of Filipino and European ancestry; Baylor Fredrickson, a Japanese-German eight-year-old in California; and Leni Hsiao, a Chinese-Jewish baby in Brooklyn.

But no story has taken off quite like Lara’s. Within days, her campaign was attracting attention from international celebrities. J.K. Rowling, Stephen Fry, Mark Wahlberg and Mario Testino tweeted with the hashtag “#match4lara.” The Casalotti family appeared on the BBC and CBS. On Wednesday, Prime Minister David Cameron spoke about Lara’s campaign in Parliament.

Lara’s story has “both the key components of a ‘viral’ campaign,” said Karen Nelson Field, author of Viral Marketing: The Science of Sharing. “High arousal content shares twice as much as low arousal content. Lara’s life depends on this — couldn’t get more emotive than that.” The other crucial ingredient was the early attention from celebrities. “Up front distribution is a key driver of success in getting content shared,” said Nelson-Field. “Having an A-level celebrity push out the content is a ‘money can’t buy’ reach opportunity.” Kristin Tynski, who oversees viral campaigns at content marketing agency Fractl, analyzed the timeline of the campaign’s spread — and credits Lara’s classmates on Reddit and Twitter with helping to get the initial word out. (Over 13,000 people “like” her Facebook page, including many of her classmates from Bristol or University College London; some of the earliest articles were in student newspapers.)


Though Lara hasn’t yet found a match, her supporters have proved that this is more than just a social media campaign. In the ten days after her website launched, 6,700 people joined the Anthony Nolan registry—a 500 percent increase over the same period last year. Gillespie expects Lara’s campaign to help recruit thousands of donors in the U.S., too.

Signing up is simple: volunteers can swab their cheeks at a donor registry drive, or request a swab kit online from Be the Match in the U.S. (or Anthony Nolan in the UK). Potential donors’ samples are then analyzed and stored; donors are only contacted if a match shows up. Only about 1 in every 300 members of the registry will ever be called on to donate, according to Be the Match.

In the event that a match does turn up, a donor can provide stem cells through one of two methods. (The doctor picks.) For a peripheral blood cell donation, the donor undergoes a week’s worth of daily injections, to increase the amount of stem cells in the blood—which is then drawn through a needle in the arm. About 25 percent of the time, the doctor requests bone marrow donation, a more intensive procedure in which liquid marrow is extracted from the donor’s pelvic bones. That operation takes place under anesthesia and usually leaves donors sore for a few days, but “It’s a fairly simple procedure, considering where it’s going and what it’s doing for somebody else,” Gillespie said.

Nearly one in eight children in London is mixed-race, and the U.S.’s multi-ethnic population grew by nearly 50 percent between 2000 and 2010. Clearly, the need to diversify the registry is only going to increase.


For more information on the #Match4Lara campaign and The Mixed Project, visit the website, or follow @the_mixed_project on Instagram.