Thursday, October 15, 2009
Bone Marrow Aspiration
A bone marrow aspiration occurs when a medical profession withdraws liquid from within the bone.
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Treatment
In secondary aplastic anemia, removing the cause is critical. In some cases it can lead to recovery.
Mild Aplastic Anemia
Mild cases of aplastic anemia may be treated with supportive care, or may not need treatment. Blood and platelet transfusions will help correct the abnormal blood counts and relieve some symptoms in moderate cases.
Mild Aplastic Anemia
Severe aplastic anemia, which causes a very low blood-cell count, is a life-threatening condition. Younger patients with a severe case of the disease will need a bone marrow transplant. Older patients, or those who do not have a matched bone marrow donor, can be treated with medications that suppress the immune system, such as antithymocyte globulin (ATG), tacrolimus, or cyclosporine.
ATG - Antithymocyte Globulin
ATG consists of antibodies made in horses or rabbits against a type of white blood cell in humans called T cells. It is used to suppress the body's immune system, allowing the bone marrow to start generating blood cells again.
Cyclosporine, Cytoxan
Other medications to suppress the immune system, such as cyclosporine, tacrolimus, and cyclophosphamide (Cytoxan) also may be used. Corticosteroids and androgens have been used as well.
http://healthtools.aarp.org/adamcontent/secondary-aplastic-anemia
Mild Aplastic Anemia
Mild cases of aplastic anemia may be treated with supportive care, or may not need treatment. Blood and platelet transfusions will help correct the abnormal blood counts and relieve some symptoms in moderate cases.
Mild Aplastic Anemia
Severe aplastic anemia, which causes a very low blood-cell count, is a life-threatening condition. Younger patients with a severe case of the disease will need a bone marrow transplant. Older patients, or those who do not have a matched bone marrow donor, can be treated with medications that suppress the immune system, such as antithymocyte globulin (ATG), tacrolimus, or cyclosporine.
ATG - Antithymocyte Globulin
ATG consists of antibodies made in horses or rabbits against a type of white blood cell in humans called T cells. It is used to suppress the body's immune system, allowing the bone marrow to start generating blood cells again.
Cyclosporine, Cytoxan
Other medications to suppress the immune system, such as cyclosporine, tacrolimus, and cyclophosphamide (Cytoxan) also may be used. Corticosteroids and androgens have been used as well.
http://healthtools.aarp.org/adamcontent/secondary-aplastic-anemia
Causes Of Aplastic Anemia
50% of the people diagnosed with aplastic anemia do not know the cause, nor is the cause ever determined. When the cause is unknown, it is referred to as idiopathic aplastic anemia. The other half can trace the disease back to one of the following causes:
- Exposure to insecticides
- Exposure to pesticides
- Exposure to chemical toxins
- Ingestation of arsenic
- Certain drugs
- Chemotherapy
- Disorders present at birth (congenital disorders)
- Drug therapy to suppress the immune system
- Pregnancy
- Radiation therapy
- Toxins such as benzene or arsenic
Bone Marrow Biopsy
What is a bone marrow biopsy? It is the extraction of a segment of bone and tissue usually taken from the hip area (alternatively from the breast bone area) along with an aspiration of the fluid within the bone.
In most situations, the area at which the biopsy will be performed is numbed, a small incision is made in the skin, and numbing medication is inserted into the body gradually numbing deeper with each new needle insertion.
Once numb, a tool is inserted into the incision and worked downward toward the bone, and then screwed into the bone into the marrow. A biopsy of the bone and marrow are extracted, and an aspiration of the marrow liquid is taken.
No stitches are needed, but a bandage is placed over the incision which must remain there for 24 hours. Until the incision is healed, the patient may not sit in water (includes baths, pools, lakes, etc.).
Afterwards, the patient may feel discomfort with the biopsy area, but no other effects are common.
In situations in which a donor is donating bone marrow, the donor is placed under general anesthia before the procedure begins. Commonly, three incisions are made on each side of the hip, each incision about 2 cm. A sufficient number of bone marrow biopsies are then performed through the tiny incisions, and in most cases the bone marrow (blood stem cells) are immediately fed into the recipient's body.
In most situations, the area at which the biopsy will be performed is numbed, a small incision is made in the skin, and numbing medication is inserted into the body gradually numbing deeper with each new needle insertion.
Once numb, a tool is inserted into the incision and worked downward toward the bone, and then screwed into the bone into the marrow. A biopsy of the bone and marrow are extracted, and an aspiration of the marrow liquid is taken.
No stitches are needed, but a bandage is placed over the incision which must remain there for 24 hours. Until the incision is healed, the patient may not sit in water (includes baths, pools, lakes, etc.).
Afterwards, the patient may feel discomfort with the biopsy area, but no other effects are common.
In situations in which a donor is donating bone marrow, the donor is placed under general anesthia before the procedure begins. Commonly, three incisions are made on each side of the hip, each incision about 2 cm. A sufficient number of bone marrow biopsies are then performed through the tiny incisions, and in most cases the bone marrow (blood stem cells) are immediately fed into the recipient's body.
Biologics: New Miracle Drugs
Biologics are considered the new miracle drugs. Radical recoveries are giving biologics a much-hyped reputation as miracle drugs. Biologic medicines are now the fastest-growing class of drugs in the pharmaceutical world; Avastin alone garnered nearly $3 billion in sales in 2008. Many patients today survive cancers once considered a death sentence, and those who suffer from autoimmune diseases such as multiple sclerosis or rheumatoid arthritis can regain full use of limbs once racked by crippling pain and immobility.
What makes biologic medicines unique is this: unlike conventional chemical drugs, biologics are produced by being grown inside living organisms, and specifically target human proteins that are involved in disease.
One class of biologics—known as monoclonal antibody biologics—are similar to the antibodies that the human immune system uses to fight off bacteria and viruses, only these antibodies are genetically engineered to target specific cancers.
Avastin is now also widely used to treat lung, breast, colon, and rectal cancers. Other monoclonal antibody biologics are designed to attack certain proteins (or protein receptors) on the surface of cancer cells and stop their growth. Examples of such protein inhibitors include Rituxan, which is used to treat lymphomas, and Herceptin.
Other biologics alter the function of the immune system by either suppressing or enhancing certain responses. In autoimmune diseases such as rheumatoid arthritis and psoriasis, for example, the immune system overproduces a protein that triggers a buildup of white blood cells, which leads to excessive inflammation and joint damage. Enbrel, Humira, Remicade, and other biologics in this class target that protein, called the tumor necrosis factor, and block its action. Tysabri, a biologic used to treat multiple sclerosis and Crohn's disease, blocks the passage of inflammatory cells into the brain and the spinal cord—and, in the case of Crohn's disease, into the intestines.
"These biologic agents provide a degree of selectivity not achievable with conventional chemotherapy drugs," explains oncologist Oliver Press, M.D., Ph.D., of the Fred Hutchinson Cancer Research Center in Seattle. "Many of [the biologics] can produce dramatic antitumor effects without the toxicity that historically has been associated with chemotherapy and radiation."
Biologic treatments date back to 1982, when recombinant insulin was first approved in the United States for the treatment of diabetes. (A hormone originally derived from the pancreas of animals, insulin is today made synthetically from genetically engineered human bacteria.) Since then, more than 300 biologic drugs, most of them developed in the past five years, have flooded the pharmaceutical market. Today they constitute roughly 25 percent of all new drugs approved by the FDA; by 2014, industry insiders predict, more than half of the top 100 drugs will be biologics.
Biologic treatments are very expensive. A push is on to develop generic drugs.
http://www.aarp.org/health/conditions/biologics/
AARP: Biologic Drugs
What makes biologic medicines unique is this: unlike conventional chemical drugs, biologics are produced by being grown inside living organisms, and specifically target human proteins that are involved in disease.
One class of biologics—known as monoclonal antibody biologics—are similar to the antibodies that the human immune system uses to fight off bacteria and viruses, only these antibodies are genetically engineered to target specific cancers.
Avastin is now also widely used to treat lung, breast, colon, and rectal cancers. Other monoclonal antibody biologics are designed to attack certain proteins (or protein receptors) on the surface of cancer cells and stop their growth. Examples of such protein inhibitors include Rituxan, which is used to treat lymphomas, and Herceptin.
Other biologics alter the function of the immune system by either suppressing or enhancing certain responses. In autoimmune diseases such as rheumatoid arthritis and psoriasis, for example, the immune system overproduces a protein that triggers a buildup of white blood cells, which leads to excessive inflammation and joint damage. Enbrel, Humira, Remicade, and other biologics in this class target that protein, called the tumor necrosis factor, and block its action. Tysabri, a biologic used to treat multiple sclerosis and Crohn's disease, blocks the passage of inflammatory cells into the brain and the spinal cord—and, in the case of Crohn's disease, into the intestines.
"These biologic agents provide a degree of selectivity not achievable with conventional chemotherapy drugs," explains oncologist Oliver Press, M.D., Ph.D., of the Fred Hutchinson Cancer Research Center in Seattle. "Many of [the biologics] can produce dramatic antitumor effects without the toxicity that historically has been associated with chemotherapy and radiation."
Biologic treatments date back to 1982, when recombinant insulin was first approved in the United States for the treatment of diabetes. (A hormone originally derived from the pancreas of animals, insulin is today made synthetically from genetically engineered human bacteria.) Since then, more than 300 biologic drugs, most of them developed in the past five years, have flooded the pharmaceutical market. Today they constitute roughly 25 percent of all new drugs approved by the FDA; by 2014, industry insiders predict, more than half of the top 100 drugs will be biologics.
Biologic treatments are very expensive. A push is on to develop generic drugs.
http://www.aarp.org/health/conditions/biologics/
AARP: Biologic Drugs
Donor Matching HLA Test
Transplants rely upon matching donors to the recipient. For bone marrow transplants, basically, there are 6 key factors analyzed for a match. They are classified as Class 1 and Class 2 HLA markers: Class 1 (A, B, C) and Class 2 (DR, DQ, DP). For a match, the first 4 HLA markers must match, being A, B, C and DR. Matching DQ is beneficial, but not necessary. Matching DP is a bonus.
From a medical standpoint, there are 8 key factors in the matching process.
Class 1 A, HLA Locus A - must be matched
Class 1 B, HLA Locus B - must be matched
Class 1 C, HLA Locus C - must be matched
DR A - need not be matched
DR B 1 - must be matched
DR B 3, 4, 5 - patient is typed, need not be matched
DQ A 1 - need not be matched
DQ B 1 - uncertain whether matching improves success
DP A 1 - need not be matched
DP B 1 -uncertain whether matching improves success
For more information, refer to http://www.marrow.org/PHYSICIAN/Adv_in_Auto_Allo_Tx/Adv_in_HLA_Typing/index.html
From a medical standpoint, there are 8 key factors in the matching process.
Class 1 A, HLA Locus A - must be matched
Class 1 B, HLA Locus B - must be matched
Class 1 C, HLA Locus C - must be matched
DR A - need not be matched
DR B 1 - must be matched
DR B 3, 4, 5 - patient is typed, need not be matched
DQ A 1 - need not be matched
DQ B 1 - uncertain whether matching improves success
DP A 1 - need not be matched
DP B 1 -uncertain whether matching improves success
For more information, refer to http://www.marrow.org/PHYSICIAN/Adv_in_Auto_Allo_Tx/Adv_in_HLA_Typing/index.html
Donor Matching - Private Typing
Getting Tested : Pricing and Kit Ordering
** All test turnaround times are from receipt of sample at laboratory and do not include weekends/holidays.
▪▪▪▪
HLA- A,B,DR (Class I and II) STANDARD
TURNAROUND of 7-10 business days. $175.00
▪▪▪▪
HLA- A,B,DR (Class I and II) STAT
TURNAROUND of 2-4 business days. $375.00
▪▪▪▪
Price Includes:
■Shipping and handling to the donor and back to the lab of the sample. Once shipped from Kashi Clinical Laboratories, the kit will take approximately 2-4 business days for delivery. A return pre-paid air bill with mailing envelope for the return of the sample to the lab. **See alternate shipping methods below.
■All supplies, testing for the designated HLA antigens, Preparation and/or hard copy of test results. The report can also be faxed or mailed to a search coordinator or personal physician that you designate on our "Private Testing Requisition"
■A hard copy of the results sent to the donor for his/her own medical records.
**Alternate Shipping Methods:
■Priority Overnight: please add $35 per kit.
■International Shipping: please add $150.00 per order.
▪▪▪▪
IMPORTANT:
Approximately 20% of all samples may require additional testing in the form of a "repeat" test or "high-resolution" test. This is not the fault of the donor but possibly the manner in which the sample was collected or shipped, or additional testing is required in order to resolve specific serological ambiguities. This re-test will delay results past the original time quoted. Kashi Clinical Laboratories does not refund testing fees or accept any liability if this condition delays results or complete typing cannot be obtained from the sample submitted.
▪▪▪▪
RETURN POLICY:
No returns on donor kits. Credit can be applied to buyer's credit card if extenuating circumstances prevent donation and only within 60 days of purchase. A 25% handling charge applies and will be deducted from any credit.
▪▪▪▪
ALL CREDITS MUST BE PRE-AUTHORIZED
by calling 1-877-527-4452.
▪▪▪▪
For additional information about testing, you can contact us at 1-877-527-4452 between 8:30 a.m. and 5:00 p.m. Pacific Standard Time.
** All test turnaround times are from receipt of sample at laboratory and do not include weekends/holidays.
▪▪▪▪
HLA- A,B,DR (Class I and II) STANDARD
TURNAROUND of 7-10 business days. $175.00
▪▪▪▪
HLA- A,B,DR (Class I and II) STAT
TURNAROUND of 2-4 business days. $375.00
▪▪▪▪
Price Includes:
■Shipping and handling to the donor and back to the lab of the sample. Once shipped from Kashi Clinical Laboratories, the kit will take approximately 2-4 business days for delivery. A return pre-paid air bill with mailing envelope for the return of the sample to the lab. **See alternate shipping methods below.
■All supplies, testing for the designated HLA antigens, Preparation and/or hard copy of test results. The report can also be faxed or mailed to a search coordinator or personal physician that you designate on our "Private Testing Requisition"
■A hard copy of the results sent to the donor for his/her own medical records.
**Alternate Shipping Methods:
■Priority Overnight: please add $35 per kit.
■International Shipping: please add $150.00 per order.
▪▪▪▪
IMPORTANT:
Approximately 20% of all samples may require additional testing in the form of a "repeat" test or "high-resolution" test. This is not the fault of the donor but possibly the manner in which the sample was collected or shipped, or additional testing is required in order to resolve specific serological ambiguities. This re-test will delay results past the original time quoted. Kashi Clinical Laboratories does not refund testing fees or accept any liability if this condition delays results or complete typing cannot be obtained from the sample submitted.
▪▪▪▪
RETURN POLICY:
No returns on donor kits. Credit can be applied to buyer's credit card if extenuating circumstances prevent donation and only within 60 days of purchase. A 25% handling charge applies and will be deducted from any credit.
▪▪▪▪
ALL CREDITS MUST BE PRE-AUTHORIZED
by calling 1-877-527-4452.
▪▪▪▪
For additional information about testing, you can contact us at 1-877-527-4452 between 8:30 a.m. and 5:00 p.m. Pacific Standard Time.
HLA Tissue Typing
The HLA gene products can be grouped into three classes. Class I consists of the products of the genes located on the HLA-A, HLA-B, and HLA-C loci. These HLA antigens are found on all nucleated cells. Class II molecules consist of antigens inherited as genes from the HLA-DR, HLA-DQ, and HLA-DP loci. These HLA antigens are normally found only on B-lymphocytes, macrophages, monocytes, dendritic cells, endothelial cells, and activated T-lymphocytes. Class III molecules are not evaluated in histocompatibility testing.
Because the HLA loci are closely linked, the HLA antigens are inherited as a group of six antigens is called a haplotype. The probability of siblings having identical haplotypes is one in four. Therefore, siblings provide the opportunity for the best matches. They can donate bone marrow, a kidney, and a section of their livers, but they cannot donate other solid organs. Approximately 85% of transplants are organs from cadavers, and because the HLA antigens are so highly polymorphic, the chance of identical haplotypes decreases quickly.
Histocompatibility testing consists of three tests, HLA antigen typing (tissue typing), screening of the recipient for anti-HLA antibodies (antibody screen), and the lymphocyte crossmatch (compatibility test). HLA antigen typing may be performed by serological or DNA methods.
A laboratory will perform HLA typing by either the serological (blood fluid) or DNA method. In either case, HLA typing of HLA-A, HLA-B, HLA-DR, and HLADQ antigens is performed for solid organ transplants. HLA typing of HLA-C antigens is also included when tissue typing is performed for bone marrow transplants.
The antibody screen is performed in order to detect antibodies in the recipient's serum that react with HLA antigens. The most commonly used method of HLA antibody screening is the microcytotoxicity test. If an antibody against an HLA antigen is present, it will bind to the cells. The higher the number of different HLA antibodies, the lower the probability of finding a compatible match.
The third component of a histocompatibility study is the crossmatch test. In this test peripheral blood lymphocytes from the donor are separated into B and T lymphocyte populations. In the crossmatch, serum from the recipient is mixed with T-cells or B-cells from the donor. A positive finding indicates the presence of preformed antibodies in the recipient that are reactive against the donor tissues. An incompatible T-cell crossmatch contraindicates transplantation of a tissue from the T-cell donor.
Read more: http://www.surgeryencyclopedia.com/Fi-La/Human-Leukocyte-Antigen-Test.html#ixzz0U1qXSSPR
Because the HLA loci are closely linked, the HLA antigens are inherited as a group of six antigens is called a haplotype. The probability of siblings having identical haplotypes is one in four. Therefore, siblings provide the opportunity for the best matches. They can donate bone marrow, a kidney, and a section of their livers, but they cannot donate other solid organs. Approximately 85% of transplants are organs from cadavers, and because the HLA antigens are so highly polymorphic, the chance of identical haplotypes decreases quickly.
Histocompatibility testing consists of three tests, HLA antigen typing (tissue typing), screening of the recipient for anti-HLA antibodies (antibody screen), and the lymphocyte crossmatch (compatibility test). HLA antigen typing may be performed by serological or DNA methods.
A laboratory will perform HLA typing by either the serological (blood fluid) or DNA method. In either case, HLA typing of HLA-A, HLA-B, HLA-DR, and HLADQ antigens is performed for solid organ transplants. HLA typing of HLA-C antigens is also included when tissue typing is performed for bone marrow transplants.
The antibody screen is performed in order to detect antibodies in the recipient's serum that react with HLA antigens. The most commonly used method of HLA antibody screening is the microcytotoxicity test. If an antibody against an HLA antigen is present, it will bind to the cells. The higher the number of different HLA antibodies, the lower the probability of finding a compatible match.
The third component of a histocompatibility study is the crossmatch test. In this test peripheral blood lymphocytes from the donor are separated into B and T lymphocyte populations. In the crossmatch, serum from the recipient is mixed with T-cells or B-cells from the donor. A positive finding indicates the presence of preformed antibodies in the recipient that are reactive against the donor tissues. An incompatible T-cell crossmatch contraindicates transplantation of a tissue from the T-cell donor.
Read more: http://www.surgeryencyclopedia.com/Fi-La/Human-Leukocyte-Antigen-Test.html#ixzz0U1qXSSPR
Blood Transfusions Preliminary To Transplants
Blood transfusions preliminary to transplants can cause issues with the transplant due to the antigens fed into the recipient from the donor blood. HLA type matching is not done preliminary to blood transfusions.
When you get a blood transfusion, you only get red blood cells. Whole blood transfusions haven't been done in many, many years. A donated unit of blood is "spun down" and separated into three layers: Bottom is Red Blood Cells, thin layer is WBCs and platelets, and top liquid is plasma. The plasma is frozen, and platelets can be harvested from the thin layer, so nothing goes to waste.
That said, it is possible then when they separate the two, they don't squeeze off all of the WBC layer. You can ask for Leuko-poor packed RBCs. They have a filter that goes between you and the unit, and "strains" out the much bigger white cells.
Read more: http://www.surgeryencyclopedia.com/Fi-La/Human-Leukocyte-Antigen-Test.html#ixzz0U1p5btRn
When you get a blood transfusion, you only get red blood cells. Whole blood transfusions haven't been done in many, many years. A donated unit of blood is "spun down" and separated into three layers: Bottom is Red Blood Cells, thin layer is WBCs and platelets, and top liquid is plasma. The plasma is frozen, and platelets can be harvested from the thin layer, so nothing goes to waste.
That said, it is possible then when they separate the two, they don't squeeze off all of the WBC layer. You can ask for Leuko-poor packed RBCs. They have a filter that goes between you and the unit, and "strains" out the much bigger white cells.
Read more: http://www.surgeryencyclopedia.com/Fi-La/Human-Leukocyte-Antigen-Test.html#ixzz0U1p5btRn
Bone Marrow Transplants See Positive Improvements
http://health.usnews.com/usnews/health/healthday/080323/a-bone-marrow-disease-with-a-brighter-prognosis.htm
There's hope: Considered fatal as recently as two decades ago, aplastic anemia is becoming a far more manageable disease. Advances in drug therapies and improvements in the field of transplantation have slashed the death toll, allowing patients to live longer, fuller lives.
"We are getting better at treating aplastic anemia, either in getting rid of it or treating its symptoms," said Dr. Jaroslaw P. Maciejewski, with the Cleveland Clinic's Department of Hematologic Oncology and Blood Disorders.
There's hope: Considered fatal as recently as two decades ago, aplastic anemia is becoming a far more manageable disease. Advances in drug therapies and improvements in the field of transplantation have slashed the death toll, allowing patients to live longer, fuller lives.
"We are getting better at treating aplastic anemia, either in getting rid of it or treating its symptoms," said Dr. Jaroslaw P. Maciejewski, with the Cleveland Clinic's Department of Hematologic Oncology and Blood Disorders.
Graph Host Disease
Graft rejection occurs when the immune cells (T-lymphocytes) of the recipient recognize specific HLA antigens on the donor's organ as foreign. The T-lymphocytes initiate a cellular immune response that result in graft rejection. Alternatively, T-lymphocytes present in the grafted tissue may recognize the host tissues as foreign and produce a cell-mediated immune response against the recipient. This is called graft versus host disease (GVHD), and it can lead to life-threatening systemic damage in the recipient. Human leukocyte antigen testing is performed to reduce the probability of both rejection and GVHD.
Read more: http://www.surgeryencyclopedia.com/Fi-La/Human-Leukocyte-Antigen-Test.html#ixzz0U1MCXHTo
Read more: http://www.surgeryencyclopedia.com/Fi-La/Human-Leukocyte-Antigen-Test.html#ixzz0U1MCXHTo
Bone Marrow Transplant Outcomes & Results
Several factors are involved in any successful transplant, but none more important than having a donor, having that donor be an excellent match, and remaining infection free.
Bone Marrow Donors
The ideal donor is an identical male twin, and then an identical female twin. Next, a male sibling, then a female sibling. Next, a non-related male donor, then a non-related female donor. Next, a non-related male donor, then a non-related female donor. If no match is found within those groups, then testing is conducted on related donors, and if all attempts to find a donor fail, the transplant team will resort to blood stems from donor cords and parents.
http://www.marrow.org/PHYSICIAN/Tx_Indications_Timing_Referral/Tx_Outcomes_by_Disease_and_Dis/index.html#other
When siblings do not match, private potential donors will be considered. If you would like to donate to a particular person, the following website offers kits to begin the screening process: https://www.bonemarrowtest.com/pricingandkitordering.htm.
If you wish to register with the national registry to donate to anyone with whom your marrow is matched, please visit http://www.marrow.org/.
Transplant Outcomes
The outcome of a transplant depends greatly on the level of matching between the donor and the patient, and then upon the age of the patient at the time of the transplant.
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Bone Marrow Donors
The ideal donor is an identical male twin, and then an identical female twin. Next, a male sibling, then a female sibling. Next, a non-related male donor, then a non-related female donor. Next, a non-related male donor, then a non-related female donor. If no match is found within those groups, then testing is conducted on related donors, and if all attempts to find a donor fail, the transplant team will resort to blood stems from donor cords and parents.
http://www.marrow.org/PHYSICIAN/Tx_Indications_Timing_Referral/Tx_Outcomes_by_Disease_and_Dis/index.html#other
When siblings do not match, private potential donors will be considered. If you would like to donate to a particular person, the following website offers kits to begin the screening process: https://www.bonemarrowtest.com/pricingandkitordering.htm.
If you wish to register with the national registry to donate to anyone with whom your marrow is matched, please visit http://www.marrow.org/.
Transplant Outcomes
The outcome of a transplant depends greatly on the level of matching between the donor and the patient, and then upon the age of the patient at the time of the transplant.
Bone Marrow Typing
What is bone marrow typing?
Bone marrow typing is the processs of identifying the HLA - human leukocyte antigen - markers on blood cells. During the typing process, proteins on blood cells are analyzed. To obtain the tissue samples for analysis, a blood draw is taken from the patient and the potential donors.
The human leukocyte antigen (HLA) test, also known as HLA typing or tissue typing, identifies antigens on the white blood cells (WBCs) that determine tissue compatibility for organ transplantation (that is, histocompatibility testing). There are six loci on chromosome 6, where the genes that produce HLA antigens are inherited: HLA-A, HLA-B, HLA-C, HLA-DR, HLA-DQ, and HLA-DP.
Currently, medical teams seek to match 4 of the 6 markers: Class 1 A, B and C, along with Class 2 DR loci. DQ matching is preferable, but not mandatory. DP matching is beneficial, but also not required.
Unlike most blood group antigens, which are inherited as products of two alleles (types of gene that occupy the same site on a chromosome), many different alleles can be inherited at each of the HLA loci. These are defined by antibodies (antisera) that recognize specific HLA antigens, or by DNA probes that recognize the HLA allele. Using specific antibodies, 26 HLA-A alleles, 59 HLA-B alleles, 10 HLA-C alleles, 26 HLA-D alleles, 22 HLA-DR alleles, nine HLA-DQ alleles, and six HLA-DP alleles can be recognized. This high degree of genetic variability (polymorphism) makes finding compatible organs more difficult than finding compatible blood for transfusion.
Read more: http://www.surgeryencyclopedia.com/Fi-La/Human-Leukocyte-Antigen-Test.html#ixzz0TyvXKnQG
Private Typing
If you wish to register to donate to any matched recipient, then the national registry is the route to go to begin typing your tissue. If however, you wish to be tested for a match to a particular donor, then the following source should be used:
https://www.bonemarrowtest.com/pricingandkitordering.htm
Bone marrow typing is the processs of identifying the HLA - human leukocyte antigen - markers on blood cells. During the typing process, proteins on blood cells are analyzed. To obtain the tissue samples for analysis, a blood draw is taken from the patient and the potential donors.
The human leukocyte antigen (HLA) test, also known as HLA typing or tissue typing, identifies antigens on the white blood cells (WBCs) that determine tissue compatibility for organ transplantation (that is, histocompatibility testing). There are six loci on chromosome 6, where the genes that produce HLA antigens are inherited: HLA-A, HLA-B, HLA-C, HLA-DR, HLA-DQ, and HLA-DP.
Currently, medical teams seek to match 4 of the 6 markers: Class 1 A, B and C, along with Class 2 DR loci. DQ matching is preferable, but not mandatory. DP matching is beneficial, but also not required.
Unlike most blood group antigens, which are inherited as products of two alleles (types of gene that occupy the same site on a chromosome), many different alleles can be inherited at each of the HLA loci. These are defined by antibodies (antisera) that recognize specific HLA antigens, or by DNA probes that recognize the HLA allele. Using specific antibodies, 26 HLA-A alleles, 59 HLA-B alleles, 10 HLA-C alleles, 26 HLA-D alleles, 22 HLA-DR alleles, nine HLA-DQ alleles, and six HLA-DP alleles can be recognized. This high degree of genetic variability (polymorphism) makes finding compatible organs more difficult than finding compatible blood for transfusion.
Read more: http://www.surgeryencyclopedia.com/Fi-La/Human-Leukocyte-Antigen-Test.html#ixzz0TyvXKnQG
Private Typing
If you wish to register to donate to any matched recipient, then the national registry is the route to go to begin typing your tissue. If however, you wish to be tested for a match to a particular donor, then the following source should be used:
https://www.bonemarrowtest.com/pricingandkitordering.htm
Wednesday, October 14, 2009
Potential Donors - Am I a donor? Can I be a donor?
When it is determined that a bone marrow transplant should or will take place, the next step is to find a suitable donor. The primary candidates for a suitable donor are the siblings of the intended recipient. There is a 25% chance of each sibling matching. If a sibling does not match, then the next step is to go to the National Bone Marrow Registry to seek a donor. Information about the process of donating, how bone marrow is matched and how to be a donor is provided below.
Listed Potential Donors
If you have been listed as a potential donor for a person who will need a bone marrow transplant, that person's cancer team will direct you to the appropriate facility for collection of your blood sample or buckle test (cheek swab), typing and communication of your typing. They will likely call you shortly after a determination has been made that a bone marrow transplant either is or may be done. They will give you the name and address of the location to which they want you to go to. When you arrive, they will process your paperwork, confirming your identity and proceed to take a sample of your blood or a swab sample from the incide of your cheek (buckle test). In almost all instances, it will be the original cancer team that will contact you to inform you of whether you are a bone marrow match.
Unlisted Potential Donors
If you are not listed as a potential donor on the recipient's donor list, it is likely because you are not the potential recipient's sibling; only siblings are listed and contacted in the first steps of seeking a matched donor. If a sibling does not match, then the next step is to seek a donor from the national registry, or if there are people who want to be considered as a donor then from their results.
Can I Be A Donor?
Perhaps. There are two types of donors - those who want to donate to a particular person, and those who want to donote to anyone with whom they match. The type of donor you wish to be determines the method for your testing.
Anonymous Donors Registry
If you wish to become a registered donor with the national registry, which would include being assessed for your desired recipient if time permits for your results to be entered into the national database in time for your intended recipient's search. The national registry process takes more time to process donor information, so that must be taken into consideration. But the national registry is free. The process is quite simple. You register, answer a few health questions for preliminary acceptance, and ask that a kit be sent to you; you swab the inside of your cheek, send the results back, and are listed in the registry. IF YOU WANT TO USE THE FREE SERVICES OF THE REGISTRY, BE SURE TO ASK THAT YOUR RESULTS BE MAILED TO YOU AS WELL AS ADDED TO THE REGISTRY. Remember, that listing with the national registry is a committment on your part stating that you will donate to anyone if asked. For private matching, please see private matching below. More information about the national registry is available at their website, http://www.marrow.org/.
In all instances, the testing process through the registry is free. If you are an intended recipient's sibling, it is very likely that the recipient's insurance company will cover the costs of the test.
Private Bone Marrow Donor Matching
If you wish to be tested for matching to a particular intended recipient, then the national registry is not the way to go. Rather, you should seek information on the website, http://www.bonemarrowtest.com/.
To be tested to match a particular intended recipient, you will need to find a collection center near you. Because the HL Testing process is unique, it is not done by most doctors or hospitals.
The second step is to ask your insurance company if they will cover the costs for you to be tested for an intended recipient (in most cases, they won't if you are not a sibling). The cost of the test is dependant upon the type of HLA test being conducted. In the preliminary testing process, it would likely be sufficient to test for Class 1 AB HLA Matching. If those two factors match, you can then be tested for the subsequent factors (Class 1 C, Class 2 DR, DQ and DP). If time is of the essence, you may want to be tested for Class 1 ABC, Class 2 DR; and if cost is not a factor for an additional one test, then also DQ; and lastly, if it is not cost prohibitive, then for DP.
Be sure to ask that your results be mailed to you. When you receive them, you can then fax them to the coordinator for the intended recipient's bone marrow matching.
See Bone Marrow Matching for more information.
Listed Potential Donors
If you have been listed as a potential donor for a person who will need a bone marrow transplant, that person's cancer team will direct you to the appropriate facility for collection of your blood sample or buckle test (cheek swab), typing and communication of your typing. They will likely call you shortly after a determination has been made that a bone marrow transplant either is or may be done. They will give you the name and address of the location to which they want you to go to. When you arrive, they will process your paperwork, confirming your identity and proceed to take a sample of your blood or a swab sample from the incide of your cheek (buckle test). In almost all instances, it will be the original cancer team that will contact you to inform you of whether you are a bone marrow match.
Unlisted Potential Donors
If you are not listed as a potential donor on the recipient's donor list, it is likely because you are not the potential recipient's sibling; only siblings are listed and contacted in the first steps of seeking a matched donor. If a sibling does not match, then the next step is to seek a donor from the national registry, or if there are people who want to be considered as a donor then from their results.
Can I Be A Donor?
Perhaps. There are two types of donors - those who want to donate to a particular person, and those who want to donote to anyone with whom they match. The type of donor you wish to be determines the method for your testing.
Anonymous Donors Registry
If you wish to become a registered donor with the national registry, which would include being assessed for your desired recipient if time permits for your results to be entered into the national database in time for your intended recipient's search. The national registry process takes more time to process donor information, so that must be taken into consideration. But the national registry is free. The process is quite simple. You register, answer a few health questions for preliminary acceptance, and ask that a kit be sent to you; you swab the inside of your cheek, send the results back, and are listed in the registry. IF YOU WANT TO USE THE FREE SERVICES OF THE REGISTRY, BE SURE TO ASK THAT YOUR RESULTS BE MAILED TO YOU AS WELL AS ADDED TO THE REGISTRY. Remember, that listing with the national registry is a committment on your part stating that you will donate to anyone if asked. For private matching, please see private matching below. More information about the national registry is available at their website, http://www.marrow.org/.
In all instances, the testing process through the registry is free. If you are an intended recipient's sibling, it is very likely that the recipient's insurance company will cover the costs of the test.
Private Bone Marrow Donor Matching
If you wish to be tested for matching to a particular intended recipient, then the national registry is not the way to go. Rather, you should seek information on the website, http://www.bonemarrowtest.com/.
To be tested to match a particular intended recipient, you will need to find a collection center near you. Because the HL Testing process is unique, it is not done by most doctors or hospitals.
The second step is to ask your insurance company if they will cover the costs for you to be tested for an intended recipient (in most cases, they won't if you are not a sibling). The cost of the test is dependant upon the type of HLA test being conducted. In the preliminary testing process, it would likely be sufficient to test for Class 1 AB HLA Matching. If those two factors match, you can then be tested for the subsequent factors (Class 1 C, Class 2 DR, DQ and DP). If time is of the essence, you may want to be tested for Class 1 ABC, Class 2 DR; and if cost is not a factor for an additional one test, then also DQ; and lastly, if it is not cost prohibitive, then for DP.
Be sure to ask that your results be mailed to you. When you receive them, you can then fax them to the coordinator for the intended recipient's bone marrow matching.
See Bone Marrow Matching for more information.
Blood Type & Bone Marrow Transplants
Blood types do not matter, and are not used in the bone marrow matching process; before marrow is transplanted, existing bone marrow and blood stem cells are destroyed. During marrow transplants, new blood stem cells are interveneously injected into the bloodstream of the recipient to make their way into the marrow. Remaining blood cells in the recipient die off within hours of the initiation of a transplant (as they were radiated prior to the transplant). The transplanted marrow then builds new blood stem cells, and in some situations the recipient's blood type will change.
Cytoxan
Using high doses of cyclophosphamide (Cytoxan®) for immunosuppression is controversial. Cyclophosphamide is a chemotherapy drug that can suppress the immune system and damage T-lymphocytes. Although this treatment can be effective, many experts believe that it is more dangerous than ATG. Most doctors in the United States prefer to delay using cyclophosphamide until ATG and cyclosporine are no longer working.
Allogeneic Transplants
An allogeneic transplant is a transplant that comes from another person.
Bone Marrow or Stem Cell Transplant
Stem cells are cells in the bone marrow (the spongy, liquid center of certain bones) that constantly make blood cells for the body. Stem cell transplants are used to restock the bone marrow when it has been destroyed by chemotherapy, radiation, or disease. Stem cells can be taken from bone marrow or blood. Stem cells may be the patient's own (autologous), or they may come from someone else (allogeneic).
Bone marrow transplants (BMTs) were the first method for replacing stem cells, but are used less often today. Now, peripheral blood stem cell transplant (SCT) is the most common method. In peripheral blood stem cell donation, stem cells are taken from circulating blood. Before collection, the donor must take special medicines to cause stem cells to grow and enter the bloodstream.
Bone Marrow or Stem Cell Transplant
Stem cells are cells in the bone marrow (the spongy, liquid center of certain bones) that constantly make blood cells for the body. Stem cell transplants are used to restock the bone marrow when it has been destroyed by chemotherapy, radiation, or disease. Stem cells can be taken from bone marrow or blood. Stem cells may be the patient's own (autologous), or they may come from someone else (allogeneic).
Bone marrow transplants (BMTs) were the first method for replacing stem cells, but are used less often today. Now, peripheral blood stem cell transplant (SCT) is the most common method. In peripheral blood stem cell donation, stem cells are taken from circulating blood. Before collection, the donor must take special medicines to cause stem cells to grow and enter the bloodstream.
Aplastic Anemia Pre-transplant Radiation Treatment & Effects
Radiation is used for treatment of some types of cancers. It is also used to treat a patient prior to a bone marrow transplant. Prior to a bone marrow transplant (or stem cell transplant), total body radiation is used to kill the immune system and bone marrow. Typically, a level 12 radiation is used (comparatively, breast cancer radiation levels are usually at 40).
During Radiation
Extra precautions to take during and after radiation treatment include dietary changes, skin protection, clothing (not wearing tight clothes), and getting plenty of rest. For more information, see Radiation Treatment Care: http://www.cancer.org/docroot/MBC/content/MBC_2_3x_What_Can_I_Do_to_Take_Care_of_Myself_during_Therapy.asp?sitearea=MBC
Effects of Radiation
Radiation can cause fatigue, loss of hair, eating problems (particularly nauseau, sores in the mouth).
Brain Radiation
Stereotactic radiosurgery is often used when cancer has only spread to a few sites in the brain. Side effects vary depending on where the radiation is aimed, and usually become most serious 1 to 2 years after treatment. Talk with your radiation oncologist about what to watch for and when to call for help.
Sometimes the whole brain is treated with radiation when cancer has spread into many sites. This may also be done to prevent cancer from spreading to the brain. Whole brain radiation can cause some of the following side effects:
Stomach & Intestinal Radiation
http://www.cancer.org/docroot/MBC/content/MBC_2_3X_What_Side_Effects_Occur_With_Radiation_Therapy_to_the_Stomach_and_Abdomen_Area.asp?sitearea=MBC
During Radiation
Extra precautions to take during and after radiation treatment include dietary changes, skin protection, clothing (not wearing tight clothes), and getting plenty of rest. For more information, see Radiation Treatment Care: http://www.cancer.org/docroot/MBC/content/MBC_2_3x_What_Can_I_Do_to_Take_Care_of_Myself_during_Therapy.asp?sitearea=MBC
Effects of Radiation
Radiation can cause fatigue, loss of hair, eating problems (particularly nauseau, sores in the mouth).
Brain Radiation
Stereotactic radiosurgery is often used when cancer has only spread to a few sites in the brain. Side effects vary depending on where the radiation is aimed, and usually become most serious 1 to 2 years after treatment. Talk with your radiation oncologist about what to watch for and when to call for help.
Sometimes the whole brain is treated with radiation when cancer has spread into many sites. This may also be done to prevent cancer from spreading to the brain. Whole brain radiation can cause some of the following side effects:
- headaches
- swelling of the brain
- hair loss
- nausea
- vomiting
- fatigue
- hearing loss
- skin and scalp changes
- trouble with memory and speech
- seizures
Stomach & Intestinal Radiation
http://www.cancer.org/docroot/MBC/content/MBC_2_3X_What_Side_Effects_Occur_With_Radiation_Therapy_to_the_Stomach_and_Abdomen_Area.asp?sitearea=MBC
Tuesday, October 13, 2009
Cord Blood Collection
http://en.wikipedia.org/wiki/Cord_blood discusses cord blood collection and preservation for future use.
Much of the general public is somewhat aware of embryonic stem cells because of the controversy associated with them. However, cord blood stem cells (hematopoietic stem cells) are not embryonic stem cells (pluripotent stem cells).
Umbilical cord collection
Much of the general public is somewhat aware of embryonic stem cells because of the controversy associated with them. However, cord blood stem cells (hematopoietic stem cells) are not embryonic stem cells (pluripotent stem cells).
Umbilical cord collection
Donating Umbilical Cord & Cord Blood
For information about donating umbibical cords, please visit: http://www.marrow.org/HELP/Donate_Cord_Blood_Share_Life/index.html
Where to donate cords.
Where to donate cords.
Joining The Bone Marrow Registry
Be The Match Registry is the new name for the National Marrow Donor Program (NMDP) Registry.
If you joined the NMDP Registry or Be The Match Registry, in person, or online, you are part of the same registry.
If you have already given a blood sample or cheek cell sample to be tested for the registry, you do not need to join again. If you're not sure whether you've already joined, you can call 1 (800) MARROW-2 (1-800-627-7692).
If you joined the NMDP Registry or Be The Match Registry, in person, or online, you are part of the same registry.
If you have already given a blood sample or cheek cell sample to be tested for the registry, you do not need to join again. If you're not sure whether you've already joined, you can call 1 (800) MARROW-2 (1-800-627-7692).
National Bone Marrow Donor Program
The National Bone Marrow Donor Program, also described on Wikipedia, operates "Be The Match" - website at: http://www.marrow.org/. Join the registry - http://www.marrow.org/JOIN/index.html.
It is easy to join the registry:
It is easy to join the registry:
- Answer a few health questions
- Order your kit for typing
- Return your swab from your cheek
Bone Marrow Registry Limitations
There are limitations on who may register. The medical limitations are:
Medical Guidelines for Joining the Registry
When you join the Be The Match RegistrySM, you will complete a health questionnaire to confirm you meet the medical guidelines. The medical guidelines protect your health as a potential donor, as well as the health of transplant patients.
The guidelines below describe many factors that may make a person medically ineligible to join the Be The Match Registry. The guidelines listed here do not include every situation that could prevent a person from donating. If you are identified as a potential match for a patient, you will receive a physical exam to be sure it is safe — for both you and the patient — to donate.
Age
You must be between the ages of 18 and 60 to join the Be The Match Registry. Age guidelines are not meant to discriminate. They are meant to protect the safety of the donor and provide the best possible outcome for the patient. The lower age limit is based on the legal age of consent. A guardian or parent is not able to sign a release or give consent because unrelated bone marrow donation is a voluntary procedure.
The upper age limit is based on donor and patient considerations. There is a small increase in the risk of side effects from anesthesia in older donors.
AIDS/HIV
If you have been diagnosed with HIV (AIDS) you cannot register to become a potential volunteer donor listed on the Be The Match Registry. If you are at significant risk for the HIV/AIDS virus, you may not be allowed to register for a certain period of time. Contact your local donor center or contact us at 1 (800) MARROW2 (1-800-627-7692) to learn more about medical guidelines for persons who are at risk for the HIV/AIDS virus.
More information about HIV/AIDS and how it is transmitted may be found at the Department of Health and Human Services Centers for Disease Control and Prevention Web site at http://www.cdc.gov/hiv/
Allergies
If you suffer from common allergies to animals, the environment, or medications, etc., you will be allowed to register to donate. Serious or life-threatening allergies to medications or latex will need to be carefully evaluated before you may join the Be The Match Registry as a potential volunteer donor. See Asthma.
Arthritis
In general, if you have mild to moderate osteoarthritis or degenerative arthritis, you will be permitted to join the Be The Match Registry. Mild to moderate arthritis is defined as having little impact on daily activities, and is relieved by taking occasional medications. If you have arthritis affecting the spine, your condition will need to be carefully evaluated before you will be allowed to register to become a potential volunteer donor. If you have a severe medical arthritic condition such as rheumatoid, reactive, psoriatic and advanced stages of other types of arthritis, you will not be allowed to register.
Asthma
If you have asthma that is exercise-induced or is well-controlled using an inhaler (including those containing steroids), and have had no attacks requiring oral (pill) or intravenous (IV) steroids or emergency care in the past five years, you are able to register to become a potential volunteer donor. If you have asthma requiring regular/daily use of oral (pill) steroids, you will not be allowed to register.
Autoimmune Diseases
Most diseases which may be defined as auto-immune disorders, such as multiple sclerosis, systemic lupus, chronic fatigue syndrome and fibromyalgia, will prevent you from registering to become a potential volunteer donor. However, if you have a condition such as Hashimoto's or Graves' disease, you may be allowed to register as long as the disease has been successfully treated and you are medically stable.
Back, Neck, Hip and/or Spine
Common back problems such as sprains, strains and aches may not interfere with a bone marrow donation. If you have any of the following conditions, you will not be allowed to register:
Chronic back pain requiring ongoing medical treatment (including chiropractic care) and/or daily or frequent prescribed pain medication
Herniated, bulging or slipped disc anywhere along your spine diagnosed in the past 2 years
Single back surgery in the past 2 years
History of a spine fracture, if caused by bone disease
History of a spine fracture in the past 2 years, if caused by injury
Placement of rods or pins for scoliosis
History of a hip or pelvic fracture and/or repair
If you have significant back problems and/or any questions regarding your medical condition, contact your local donor center.
Bleeding Problems
You are not able to register if you have a serious bleeding problem such as hemophilia, Factor V Leiden and have had a blood clot or require anticoagulant medications, aplastic anemia, Von Willbrand’s Disease, or have a history of more than one deep vein thrombosis (blood clot). This also includes idiopathic thrombocytopenia purpura (also called ITP) — unless you only had childhood (less than 18 years old) episodes.
Blood Pressure
If you have elevated blood pressure (hypertension), you may register if your condition is well-controlled by medication or diet and if there is no associated heart disease. See Heart Disease, if applicable.
Breathing Problems
If you have serious breathing problems such as chronic obstructive pulmonary disease (COPD), emphysema, sleep apnea or cystic fibrosis, you are not able to register. See Asthma, if applicable.
Cancer
If you have a history of pre-cancerous cells, you will be able to register to become a potential volunteer donor. You are able to register if you have any of the following:
Cured, local skin cancer (basal cell, squamous cell or melanoma in situ).
Healed in situ cervical cancer.
Healed in situ breast cancer.
Healed in situ bladder cancer.
NOTE: In situ cancer is diagnosed at a very early stage and is specifically called “in situ” or Stage 0.
All other forms of cancer, including non-in situ melanoma, are not acceptable — no matter the length of time since treatment or recovery.
Cold or Flu
Recent infections, such as colds or flu will not prevent you from registering to become a potential volunteer donor.
Depression/Mental Health
If you have a history of depression that is stable and well-controlled, you may register to become a potential volunteer donor. Contact us at 1 (800) MARROW2 (1-800-627-7692) to discuss any other mental health conditions.
Diabetes
If you have diabetes, a careful evaluation of your current health status will be necessary. In general, if your diabetes is well-controlled by either diet or oral medications, you will be allowed to register. If you require insulin or any injected medications to treat diabetes or if you have diabetes-related serious health issues such as kidney, heart or eye disease, you will not be allowed to register. If you have questions regarding your diabetes, contact us at 1 (800) MARROW2 (1-800-627-7692).
Epilepsy
You may register if you have well-controlled epilepsy and have had no seizures in the past year.
Heart Disease
In general, if you have heart disease you cannot become a potential volunteer donor. This includes a past heart attack, any history of angioplasty, bypass surgery, heart valve replacement surgery or pacemakers. However, some heart conditions such as well-controlled irregular heartbeats (arrhythmias), or mitral valve prolapse that does not require medication or restrictions, or successful cardiac ablation will not prevent you from registering to become a donor. Your situation will be evaluated on an individual basis.
Hepatitis
You will be allowed to join the Be The Match Registry if you have:
Received a vaccine to prevent hepatitis
History of fully-recovered hepatitis A
Close or intimate contact with someone with active hepatitis B or C in the past year
Possible exposure to hepatitis B or C in the past year
History of jaundice due to mononucleosis or cytomegalovirus (CMV) infection
If you have the following, you cannot join the registry:
Diagnosed with hepatitis B or C
Been told you had a positive confirmatory test for hepatitis B or C
Been told you are a carrier of hepatitis B or C (also known as a “chronic” infection)
History of hepatitis or yellow jaundice (after age 10) without a known cause
If you have questions regarding hepatitis and registration, contact us at 1 (800) MARROW2 (1-800-627-7692).
More information about hepatitis and how it is transmitted may be found at the Department of Health and Human Services Centers for Disease Control and Prevention Web site at http://www.cdc.gov/ncidod/diseases/hepatitis/.
Immunizations
If you have received a common immunization, you may register to become a potential volunteer donor. If you have received an investigational vaccine, however, your situation must be evaluated. Some immunizations (such as smallpox) will require assessment if you are selected as a potential donor.
Kidney Problems
You cannot register if you have serious or chronic kidney problems such as polycystic kidney disease or glomerulonephritis. If you have had a kidney removed due to disease, you cannot register. However, if you donated a kidney to another person and are now fully recovered from that surgery, you are able to register. You are able to register if you have a history of kidney stones.
Liver Disease
If you have a serious liver disease such hepatitis B, hepatitis C, cirrhosis, or Wilson’s disease, you are not able to register. You are able to register if you have Gilbert’s syndrome. See Hepatitis, if applicable.
Lyme Disease
If you have fully recovered from Lyme disease, you may register to become a potential volunteer donor. If you have chronic Lyme disease, you may not register.
Medications
Treatment with some medications may affect your suitability to register as a potential volunteer donor. Most often it is not the actual drug itself but the condition requiring the medication that would determine your suitability. If you are currently taking medication(s), you may want to contact your local donor center to discuss the medication(s) and underlying condition.
Organ or Tissue Transplant
If you have received human tissues, such as bone (including bone powder for dental procedures), ligaments, tendons, skin and corneas, you may be allowed to register to become a potential volunteer donor, depending on the reason for the procedure.
If you received any of the following types of transplants you may not register:
Human organs such as heart, lung, liver, or kidney
Marrow or blood-forming cells
Dura mater
Xenotransplant (live tissues from animals)
Piercing (Body, Skin, Ear)
You may register to become a potential volunteer donor if you have had ear or body piercing in the past year.
Pregnancy
If you are pregnant you may register for the Be The Match Registry. However, you must be temporarily deferred until you are fully recovered from the delivery or c-section. Blood-forming cells cannot be collected at any time during pregnancy.
If you are currently pregnant or planning on becoming pregnant, you may want to consider donating your baby's umbilical cord blood after your baby is born. To see if this is an option at your hospital, see Where to Donate Cord Blood.
Sexually Transmitted Diseases
If you have or have had a sexually transmitted disease such as herpes, HPV, chlamydia or syphilis you are eligible to register for the Be The Match Registry.
Tattoos
You may register if you received a tattoo in the past year.
Travel
You are allowed to register regardless of where you have traveled. If you are selected as a potential donor, recent travel to areas at risk for such infections such as malaria or mad cow disease will be evaluated.
Tuberculosis
If you have had active pulmonary tuberculosis (TB) within the last two years, you may not register. You can register if you have completed treatment for TB, if it has been more than 2 years, and you have a clear chest x-ray. You may also register if you have a history of a positive Mantoux (PPD).
Weight
A formula that measures body fat — called Body Mass Index (BMI) — is used to evaluate weight when determining donor suitability. You may not be allowed to register if your BMI (both underweight and overweight) would present a risk to your safety. See Donor Weight Guidelines for more information regarding upper weight criteria. While we do not have a guideline table listing minimum weight criteria, volunteers who are extremely underweight for their height would need to be carefully evaluated.
For more information, see: http://www.marrow.org/JOIN/Med_Guidelines_Join/index.html
Medical Guidelines for Joining the Registry
When you join the Be The Match RegistrySM, you will complete a health questionnaire to confirm you meet the medical guidelines. The medical guidelines protect your health as a potential donor, as well as the health of transplant patients.
The guidelines below describe many factors that may make a person medically ineligible to join the Be The Match Registry. The guidelines listed here do not include every situation that could prevent a person from donating. If you are identified as a potential match for a patient, you will receive a physical exam to be sure it is safe — for both you and the patient — to donate.
Age
You must be between the ages of 18 and 60 to join the Be The Match Registry. Age guidelines are not meant to discriminate. They are meant to protect the safety of the donor and provide the best possible outcome for the patient. The lower age limit is based on the legal age of consent. A guardian or parent is not able to sign a release or give consent because unrelated bone marrow donation is a voluntary procedure.
The upper age limit is based on donor and patient considerations. There is a small increase in the risk of side effects from anesthesia in older donors.
AIDS/HIV
If you have been diagnosed with HIV (AIDS) you cannot register to become a potential volunteer donor listed on the Be The Match Registry. If you are at significant risk for the HIV/AIDS virus, you may not be allowed to register for a certain period of time. Contact your local donor center or contact us at 1 (800) MARROW2 (1-800-627-7692) to learn more about medical guidelines for persons who are at risk for the HIV/AIDS virus.
More information about HIV/AIDS and how it is transmitted may be found at the Department of Health and Human Services Centers for Disease Control and Prevention Web site at http://www.cdc.gov/hiv/
Allergies
If you suffer from common allergies to animals, the environment, or medications, etc., you will be allowed to register to donate. Serious or life-threatening allergies to medications or latex will need to be carefully evaluated before you may join the Be The Match Registry as a potential volunteer donor. See Asthma.
Arthritis
In general, if you have mild to moderate osteoarthritis or degenerative arthritis, you will be permitted to join the Be The Match Registry. Mild to moderate arthritis is defined as having little impact on daily activities, and is relieved by taking occasional medications. If you have arthritis affecting the spine, your condition will need to be carefully evaluated before you will be allowed to register to become a potential volunteer donor. If you have a severe medical arthritic condition such as rheumatoid, reactive, psoriatic and advanced stages of other types of arthritis, you will not be allowed to register.
Asthma
If you have asthma that is exercise-induced or is well-controlled using an inhaler (including those containing steroids), and have had no attacks requiring oral (pill) or intravenous (IV) steroids or emergency care in the past five years, you are able to register to become a potential volunteer donor. If you have asthma requiring regular/daily use of oral (pill) steroids, you will not be allowed to register.
Autoimmune Diseases
Most diseases which may be defined as auto-immune disorders, such as multiple sclerosis, systemic lupus, chronic fatigue syndrome and fibromyalgia, will prevent you from registering to become a potential volunteer donor. However, if you have a condition such as Hashimoto's or Graves' disease, you may be allowed to register as long as the disease has been successfully treated and you are medically stable.
Back, Neck, Hip and/or Spine
Common back problems such as sprains, strains and aches may not interfere with a bone marrow donation. If you have any of the following conditions, you will not be allowed to register:
Chronic back pain requiring ongoing medical treatment (including chiropractic care) and/or daily or frequent prescribed pain medication
Herniated, bulging or slipped disc anywhere along your spine diagnosed in the past 2 years
Single back surgery in the past 2 years
History of a spine fracture, if caused by bone disease
History of a spine fracture in the past 2 years, if caused by injury
Placement of rods or pins for scoliosis
History of a hip or pelvic fracture and/or repair
If you have significant back problems and/or any questions regarding your medical condition, contact your local donor center.
Bleeding Problems
You are not able to register if you have a serious bleeding problem such as hemophilia, Factor V Leiden and have had a blood clot or require anticoagulant medications, aplastic anemia, Von Willbrand’s Disease, or have a history of more than one deep vein thrombosis (blood clot). This also includes idiopathic thrombocytopenia purpura (also called ITP) — unless you only had childhood (less than 18 years old) episodes.
Blood Pressure
If you have elevated blood pressure (hypertension), you may register if your condition is well-controlled by medication or diet and if there is no associated heart disease. See Heart Disease, if applicable.
Breathing Problems
If you have serious breathing problems such as chronic obstructive pulmonary disease (COPD), emphysema, sleep apnea or cystic fibrosis, you are not able to register. See Asthma, if applicable.
Cancer
If you have a history of pre-cancerous cells, you will be able to register to become a potential volunteer donor. You are able to register if you have any of the following:
Cured, local skin cancer (basal cell, squamous cell or melanoma in situ).
Healed in situ cervical cancer.
Healed in situ breast cancer.
Healed in situ bladder cancer.
NOTE: In situ cancer is diagnosed at a very early stage and is specifically called “in situ” or Stage 0.
All other forms of cancer, including non-in situ melanoma, are not acceptable — no matter the length of time since treatment or recovery.
Cold or Flu
Recent infections, such as colds or flu will not prevent you from registering to become a potential volunteer donor.
Depression/Mental Health
If you have a history of depression that is stable and well-controlled, you may register to become a potential volunteer donor. Contact us at 1 (800) MARROW2 (1-800-627-7692) to discuss any other mental health conditions.
Diabetes
If you have diabetes, a careful evaluation of your current health status will be necessary. In general, if your diabetes is well-controlled by either diet or oral medications, you will be allowed to register. If you require insulin or any injected medications to treat diabetes or if you have diabetes-related serious health issues such as kidney, heart or eye disease, you will not be allowed to register. If you have questions regarding your diabetes, contact us at 1 (800) MARROW2 (1-800-627-7692).
Epilepsy
You may register if you have well-controlled epilepsy and have had no seizures in the past year.
Heart Disease
In general, if you have heart disease you cannot become a potential volunteer donor. This includes a past heart attack, any history of angioplasty, bypass surgery, heart valve replacement surgery or pacemakers. However, some heart conditions such as well-controlled irregular heartbeats (arrhythmias), or mitral valve prolapse that does not require medication or restrictions, or successful cardiac ablation will not prevent you from registering to become a donor. Your situation will be evaluated on an individual basis.
Hepatitis
You will be allowed to join the Be The Match Registry if you have:
Received a vaccine to prevent hepatitis
History of fully-recovered hepatitis A
Close or intimate contact with someone with active hepatitis B or C in the past year
Possible exposure to hepatitis B or C in the past year
History of jaundice due to mononucleosis or cytomegalovirus (CMV) infection
If you have the following, you cannot join the registry:
Diagnosed with hepatitis B or C
Been told you had a positive confirmatory test for hepatitis B or C
Been told you are a carrier of hepatitis B or C (also known as a “chronic” infection)
History of hepatitis or yellow jaundice (after age 10) without a known cause
If you have questions regarding hepatitis and registration, contact us at 1 (800) MARROW2 (1-800-627-7692).
More information about hepatitis and how it is transmitted may be found at the Department of Health and Human Services Centers for Disease Control and Prevention Web site at http://www.cdc.gov/ncidod/diseases/hepatitis/.
Immunizations
If you have received a common immunization, you may register to become a potential volunteer donor. If you have received an investigational vaccine, however, your situation must be evaluated. Some immunizations (such as smallpox) will require assessment if you are selected as a potential donor.
Kidney Problems
You cannot register if you have serious or chronic kidney problems such as polycystic kidney disease or glomerulonephritis. If you have had a kidney removed due to disease, you cannot register. However, if you donated a kidney to another person and are now fully recovered from that surgery, you are able to register. You are able to register if you have a history of kidney stones.
Liver Disease
If you have a serious liver disease such hepatitis B, hepatitis C, cirrhosis, or Wilson’s disease, you are not able to register. You are able to register if you have Gilbert’s syndrome. See Hepatitis, if applicable.
Lyme Disease
If you have fully recovered from Lyme disease, you may register to become a potential volunteer donor. If you have chronic Lyme disease, you may not register.
Medications
Treatment with some medications may affect your suitability to register as a potential volunteer donor. Most often it is not the actual drug itself but the condition requiring the medication that would determine your suitability. If you are currently taking medication(s), you may want to contact your local donor center to discuss the medication(s) and underlying condition.
Organ or Tissue Transplant
If you have received human tissues, such as bone (including bone powder for dental procedures), ligaments, tendons, skin and corneas, you may be allowed to register to become a potential volunteer donor, depending on the reason for the procedure.
If you received any of the following types of transplants you may not register:
Human organs such as heart, lung, liver, or kidney
Marrow or blood-forming cells
Dura mater
Xenotransplant (live tissues from animals)
Piercing (Body, Skin, Ear)
You may register to become a potential volunteer donor if you have had ear or body piercing in the past year.
Pregnancy
If you are pregnant you may register for the Be The Match Registry. However, you must be temporarily deferred until you are fully recovered from the delivery or c-section. Blood-forming cells cannot be collected at any time during pregnancy.
If you are currently pregnant or planning on becoming pregnant, you may want to consider donating your baby's umbilical cord blood after your baby is born. To see if this is an option at your hospital, see Where to Donate Cord Blood.
Sexually Transmitted Diseases
If you have or have had a sexually transmitted disease such as herpes, HPV, chlamydia or syphilis you are eligible to register for the Be The Match Registry.
Tattoos
You may register if you received a tattoo in the past year.
Travel
You are allowed to register regardless of where you have traveled. If you are selected as a potential donor, recent travel to areas at risk for such infections such as malaria or mad cow disease will be evaluated.
Tuberculosis
If you have had active pulmonary tuberculosis (TB) within the last two years, you may not register. You can register if you have completed treatment for TB, if it has been more than 2 years, and you have a clear chest x-ray. You may also register if you have a history of a positive Mantoux (PPD).
Weight
A formula that measures body fat — called Body Mass Index (BMI) — is used to evaluate weight when determining donor suitability. You may not be allowed to register if your BMI (both underweight and overweight) would present a risk to your safety. See Donor Weight Guidelines for more information regarding upper weight criteria. While we do not have a guideline table listing minimum weight criteria, volunteers who are extremely underweight for their height would need to be carefully evaluated.
For more information, see: http://www.marrow.org/JOIN/Med_Guidelines_Join/index.html
Monday, October 12, 2009
State U.S. Representatives
Where to fax your Representative:
Alabama
Gov. Bob Riley (R) 334-242-7100
State Legislature Links
Sen. Jeff Sessions (R) Fax: 202-224-3149
Sen. Richard C. Shelby (R) Fax: 202-224-3416
Rep. Jo Bonner (R-1) Fax: 202-225-0562
Rep. Bobby Bright (D-2) Fax: 202-225-8913
Rep. Michael Rogers (R-3) Fax: 202-226-8485
Rep. Robert Aderholt (R-4) Fax: 202-225-5587
Rep. Parker Griffith (D-5) Fax: 202-225-4392
Rep. Spencer Bachus (R-6) Fax: 202-225-2082
Rep. Artur Davis (D-7) Fax: 202-226-9567
Alaska
Gov. Sean Parnell (R) 907-465-3500
State Legislature Links
Sen. Lisa Murkowski (R) Fax: 202-224-5301
Sen. Mark Begich (D) Fax: 202-224-2354
Rep. Don Young (R-At Large) Fax: 202-225-0425
Arizona
Gov. Jan Brewer (R) 602-542-4331
State Legislature Links
Arizona Constitution
Sen. Jon Kyl. (R) Fax: 202-224-2207
Sen. John McCain (R) Fax: 202-228-2862
Rep. Ann Kirkpatrick (D-1) Fax: 202-226-9739
Rep. Trent Franks (R-2) Fax: 202-225-6328
Rep. John Shadegg (R-3) Fax: 202-225-3462
Rep. Ed Pastor (D-4) Fax: 202-225-1655
Rep. Harry Mitchell (D-5) Fax: 202-225-3263
Rep. Jeff Flake (R-6) Fax: 202-226-4386
Rep. Raul Grijalva (D-7) Fax: 202-225-1541
Rep. Gabrielle Giffords (D-8) Fax: 202-225-0378
Arkansas
Gov. Mike Beebe (D) 501-682-2345
State Legislature Links
Sen. Blanche Lincoln (D) Fax: 202-228-1371
Sen. Mark Pryor (D) Fax: 202-228-0908
Rep. Marion Berry (D-1) Fax: 202-225-5602
Rep. Vic Snyder (D-2) Fax: 202-225-5903
Rep. John Boozeman (R-3) Fax: 202-225-5713
Rep. Mike Ross (D-4) Fax: 202-225-1314
California
Gov. Arnold Schwarzenegger (R) Fax: 916-558-3160
State Legislature Links
Sen. Barbara Boxer (D) Fax: 415-956-6701
Sen. Dianne Feinstein (D) Fax: 202-228-3954
Rep. Mike Thompson (D-1) Fax: 202-225-4335
Rep. Wally Herger (R-2) Fax: 202-225-1740
Rep. Dan Lungren (R-3) Fax: 202-226-1298
Rep. Tom McClintock (R-4) Fax: 202-225-5444
Rep. Doris Matsui (D-5) Fax: 202-225-0566
Rep. Lynn Woolsey (D-6) Fax: 202-225-5163
Rep. George Miller (D-7) Fax: 202-225-5609
Rep. Nancy Pelosi (D-8) Fax: 202-225-8259
Non Constituent email address for Speaker Pelosi.
Rep. Barbara Lee (D-9) Fax: 202-225-9817
Vacant (-10) Fax: 202-225-5914
Rep. Jerry McNerney (D-11) Fax: 202-226-0861
Rep. Jackie Speier (D-12) Fax: 202-226-4183
Rep. Pete Stark (D-13) Fax: 202-226-3805
Rep. Anna Eshoo (D-14) Fax: 202-225-8890
Rep. Mike Honda (D-15) Fax: 202-225-2699
Rep. Zoe Lofgren (D-16) Fax: 202-225-3336
Rep. Sam Farr (D-17) Fax: 202-225-6791
Rep. Dennis Cardoza (D-18) Fax: 202-225-0819
Rep. George Radanovich (R-19) Fax: 202-225-3402
Rep. Jim Costa (D-20) Fax: 202-225-9308
Rep. Devin Nunes (R-21) Fax: 202-225-3404
Rep. Kevin McCarthy (R-22) Fax: 202-225-8798
Rep. Lois Capps (D-23) Fax: 202-225-5632
Rep. Elton Gallegly (R-24) Fax: 202-225-1100
Rep. Howard McKeon (R-25) Fax: 202-225-0683
Rep. David Dreier (R-26) Fax: 202-225-7018
Rep. Brad Sherman (D-27) Fax: 202-225-5879
Rep. Howard Berman (D-28) Fax: 202-225-3196
Rep. Adam Schiff (D-29) Fax: 202-225-5828
Rep. Henry Waxman (D-30) Fax: 202-225-4099
Rep. Xavier Becerra (D-31) Fax: 202-225-2202
Rep. Judy Chu (D-32) Fax: 202-225-5467
Rep. Diane Watson (D-33) Fax: 202-225-2422
Rep. Lucille Roybal-Allard (D-34) Fax: 202-226-0350
Rep. Maxine Waters (D-35) Fax: 202-225-7854
Rep. Jane Harman (D-36) Fax: 202-226-7290
Rep. Laura Richardson (D-37) Fax: 202-225-7926
Rep. Grace Napolitano (D-38) Fax: 202-225-0027
Rep. Linda Sanchez (D-39) Fax: 202-225-5859
Rep. Ed Royce (R-40) Fax: 202-226-0335
Rep. Jerry Lewis (R-41) Fax: 202-225-6498
Rep. Gary Miller (R-42) Fax: 202-226-6962
Rep. Joe Baca (D-43) Fax: 202-225-8671
Rep. Ken Calvert (R-44) Fax: 202-225-2004
Rep. Mary Bono (R-45) Fax: 202-225-2961
Rep. Dana Rohrabacher (R-46) Fax: 202-225-0145
Rep. Loretta Sanchez (D-47) Fax: 202-225-5859
Rep. John Campbell (R-48) Fax: 202-225-9177
Rep. Darrell Issa (R-49) Fax: 202-225-3303
Rep. Brian Bilbray (R-50) Fax: 202-225-2558
Rep. Bob Filner (D-51) Fax: 202-225-9073
Rep. Duncan Hunter (R-52) Fax: 202-225-0235
Rep. Susan Davis (D-53) Fax: 202-225-2948
Colorado
Gov. Bill Ritter (D) 303-866-2471
State Legislature Links
Sen. Mark Udall (D) Fax: 202-224-6471
Sen. Michael Bennet (D) Fax: 202-224-1933
Rep. Diana DeGette (D-1) Fax: 202-225-5657
Rep. Jared Polis (D-2) Fax: 202-226-7840
Rep. John Salazar (D-3) Fax: 202-226-9669
Rep. Betsy Markey (D-4) Fax: 202-225-5870
Rep. Doug Lamborn (R-5) Fax: 202-225-1942
Rep. Mike Coffman (R-6) Fax: 202-226-4623
Rep. Ed Perlmutter (D-7) Fax: 202-225-5278
Connecticut
Gov. Jodi Rell (R) 860-566-4840
State Legislature Links
Sen. Christopher Dodd (D) Fax: 202-224-1083
Sen. Joseph Lieberman (D) Fax: 202-224-9750
Rep. John Larson (D-1) Fax: 202-225-1031
Rep. Joe Courtney (D-2) Fax: 202-225-4977
Rep. Rosa DeLauro (D-3) Fax: 202-225-4890
Rep. Jim Himes (D-4) Fax: 202-225-9629
Rep. Chris Murphy (D-5) Fax: 202-225-4488
Delaware
Gov. Jack Markell (D) 302-739-4101
State Legislature Links
Sen. Edward Kaufman (D) Fax:
Sen. Tom Carper (D) Fax: 202-228-2190
Rep. Michael Castle (R-At Large) Fax: 202-225-2291
Florida
Gov. Charlie Crist (R) 850-488-4441
State Legislature Links
Sen. George LeMieux (R) Fax: 202-224-2237
Sen. Bill Nelson (D) Fax: 202-228-2183
Rep. Jeff Miller (R-1) Fax: 202-225-3414
Rep. F. Allen Boyd (D-2) Fax: 202-225-5615
Rep. Corrine Brown (D-3) Fax: 202-225-2256
Rep. Ander Crenshaw (R-4) Fax: 202-225-2504
Rep. Virginia Brown-Waite (R-5) Fax: 202-226-6559
Rep. Cliff Stearns (R-6) Fax: 202-225-3973
Rep. John Mica (R-7) Fax: 202-226-0821
Rep. Alan Grayson (D-8) Fax: 202-225-0999
Rep. Gus Bilirakis (R-9) Fax: 202-225-4085
Rep. Bill Young (R-10) Fax: 202-225-9764
Rep. Kathy Castor (D-11) Fax: 202-225-5652
Rep. Adam Putnam (R-12) Fax: 202-225-0585
Rep. Vern Buchanan (R-13) Fax: 202-226-0828
Rep. Connie Mack (R-14) Fax: 202-225-6820
Rep. Bill Posey (R-15) Fax: 202-225-3516
Rep. Tom Rooney (D-16) Fax: 202-225-3132
Rep. Kendrick Meek (D-17) Fax: 202-226-0777
Rep. Ileana Ros-Lehtinen (R-18) Fax: 202-225-5620
Rep. Robert Wexler (D-19) Fax: 202-225-5974
Rep. Debbie Wasserman Schultz (D-20) Fax: 202-225-8456
Rep. Lincoln Diaz-Balart (R-21) Fax: 202-225-8576
Rep. Ron Klein (D-22) Fax: 202-225-8398
Rep. Alcee Hastings (D-23) Fax: 202-225-1171
Rep. Suzanne Kosmas (D-24) Fax: 202-226-6299
Rep. Mario Diaz-Balart (R-25) Fax: 202-226-0346
Georgia
Gov. Sonny Perdue (R) 404-656-1776
State Legislature Links
Sen. Saxby Chamblis (R) Fax 202-224-0103
Sen. Johnny Isakson (R) Fax: 202-228-2090
Rep. Jack Kingston (R-1) Fax: 202-226-2269
Rep. Sanford Bishop (D-2) Fax: 202-225-2203
Rep. Lynn Westmoreland (R-3) Fax: 202-225-3013
Rep. Hank Johnson (D-4) Fax: 202-226-0691
Rep. John Lewis (D-5) Fax: 202-225-0351
Rep. Thomas Price (R-6) Fax: 202-225-4656
Rep. John Linder (R-7) Fax: 202-225-4696
Rep. Jim Marshall (D-8) Fax: 202-225-2515
Rep. Nathan Deal (R-9) Fax: 202-225-5995
Rep. Paul Broun (R-10) Fax: 202-225-8272
Rep. Phil Gingrey (R-11) Fax: 202-225-2944
Rep. John Barrow (D-12) Fax: 202-225-3377
Rep. David Scott (D-13) Fax: 202-225-4628
Hawaii
Gov. Linda Lingle (R) 808-586-0034
State Legislature Links
Sen. Daniel K. Akaka (D) Fax: 202-224-2126
Sen. Daniel K. Inouye (D) Fax: 202-224-6747
Rep. Neil Abercrombie (D-1) Fax: 202-225-4580
Rep. Mazie Hirono (D-2) Fax: 202-225-4987
Idaho
Gov. Butch Otter (R) 208-334-2100
State Legislature Links
Sen. James Risch (R) Fax: 202-228-1067
Sen. Michael Crapo (R) Fax: 202-228-1375
Rep. Walt Minnick (D-1) Fax: 202-225-3029
Rep. Michael Simpson (R-2) Fax: 202-225-8216
Illinois
Gov. Pat Quinn (D) 217-782-0244
State Legislature Links
Sen. Dick Durbin (D) Fax: 202-228-0400
Sen. Roland Burris (D) Fax: 202-228-5417
Rep. Bobby Rush (D-1) Fax: 202-226-0333
Rep. Jesse Jackson, Jr. (D-2) Fax: 202-225-0899
Rep. Daniel Lipinski (D-3) Fax: 202-225-1012
Rep. Luis Gutirrez (D-4) Fax: 202-225-7810
Rep. Mike Quigley (D-5) Fax: 202-225-5603
Rep. Peter Roskam (R-6) Fax: 202-225-1166
Rep. Danny Davis (D-7) Fax: 202-225-5641
Rep. Melissa Bean (D-8) Fax: 202-225-7830
Rep. Janice Schakowsky (D-9) Fax: 202-226-6890
Rep. Mark Kirk (R-10) Fax: 202-225-0837
Rep. Deborah Halvorson (D-11) Fax: 202-225-3521
Rep. Jerry Costello (D-12) Fax: 202-225-0285
Rep. Judy Biggert (R-13) Fax: 202-225-9420
Rep. Bill Foster (D-14) Fax: 202-225-0697
Rep. Timothy Johnson (R-15) Fax: 202-226-0791
Rep. Donald Manzullo (R-16) Fax: 202-225-5284
Rep. Philip Hare (D-17) Fax: 202-225-5396
Rep. Aaron Schock (R-18) Fax: 202-225-9249
Rep. John Shimkus (R-19) Fax: 202-225-5880
Indiana
Gov. Mitch Daniels (R) 317-232-4567
State Legislature Links
Sen. Evan Bayh (D) Fax: (202) 228-1377
Sen. Richard G. Lugar (R) Fax: 202-228-0360
Rep. Peter Visclosky (D-1) Fax: 202-225-2493
Rep. Joe Donnelly (D-2) Fax: 202-225-6798
Rep. Mark Souder (R-3) Fax: 202-225-3479
Rep. Stephen Buyer (R-4) Fax: 202-225-2267
Rep. Dan Burton (R-5) Fax: 202-225-0016
Rep. Mike Pence (R-6) Fax: 202-225-3382
Rep. André Carson (D-7) Fax: 202-225-5633
Rep. Brad Ellsworth (D-8) Fax: 202-225-3284
Rep. Baron Hill (D-9) Fax: 202-226-6866
Iowa
Gov. Chet Culver (D) 515-281-5211
State Legislature Links
Sen. Chuck Grassley (R) Fax: 202-224-6020
Sen. Tom Harkin (D) Fax: 202-224-9369
Rep. Bruce Braley (D-1) Fax: 202-225-9129
Rep. David Loebsack (D-2) Fax: 202-226-0757
Rep. Leonard Boswell (D-3) Fax: 202-225-5608
Rep. Tom Latham (R-4) Fax: 202-225-3301
Rep. Steve King (R-5) Fax: 202-225-3193
Kansas
Gov. Kathleen Sebelius (D) 785-296-3232
State Legislature Links
Sen. Sam Brownback (R) Fax: 202-228-1265
Sen. Pat Roberts (R) Fax: 202-224-3514
Rep. Jerry Moran (R-1) Fax: 202-225-5124
Rep. Lynn Jenkins (R-2) Fax: 202-225-7986
Rep. Dennis Moore (R-3) Fax: 202-225-2807
Rep. Todd Tiahrt (R-4) Fax: 202-225-3489
Kentucky
Gov. Steve Beshear (D) 502-564-2611
State Legislature Links
Sen. Jim Bunning (R) Fax: 202-228-1373
Sen. Mitch McConnell (R) Fax: 202-224-2499
Rep. Ed Whitfield (R-1) Fax: 202-225-3547
Rep. Brett Guthrie (R-2) Fax: 202-226-2019
Rep. John Yarmuth (D-3) Fax: 202-225-5776
Rep. Geoff Davis (R-4) Fax: 202-225-0003
Rep. Harold Rogers (R-5) Fax: 202-225-0940
Rep. Ben Chandler (D-6) Fax: 202-225-2122
Louisiana
Gov. Bobby Jindal (R) 225-342-0991
State Legislature Links
Sen. Mary Landrieu (D) Fax: 202-224-9735
Sen. David Vitter (R) Fax: 202-228-2577
Rep. Steve Scalise (R-1) Fax: (202) 226-0386
Rep. Joseph Cao (R-2) Fax: 202-225-1988
Rep. Charlie Melancon (D-3) Fax: (202) 226-3944
Rep. John Fleming (R-4) Fax: 202-225-8039
Rep. Rodney Alexander (D-5) Fax: 202-225-5639
Rep. Bill Cassidy (R-6) Fax: 202-225-7313
Rep. Charles Boustany (R-7) Fax: 202-225-5724
Maine
Gov. John Baldacci (D) 207-287-1034
State Legislature Links
Sen. Susan Collins (R) Fax: 202-224-2693
Sen. Olympia Snowe (R) Fax: 202-224-1946
Rep. Tom Allen (D-1) Fax: 202-225-5590
Rep. Michael Michaud (D-2) Fax: 202-225-2943
Maryland
Gov. Martin O'Malley (D) 800-811-8336
State Legislature Links
Sen. Benjamin Cardin (D) Fax: 202-224-1651
Sen. Barbara Mikulski (D) Fax: 202-224-8858
Rep. Wayne Gilchrest (R-1) Fax: 202-225-0254
Rep. "Dutch" Ruppersberger (D-2) Fax: 202-225-3094
Rep. John Sarbanes (D-3) Fax: 202-225-9219
Rep. Donna Edwards (D-4) Fax: 202-225-8714
Rep. Steny Hoyer (D-5) Fax: 202-225-4300
Rep. Roscoe Bartlett (R-6) Fax: 202-225-2193
Rep. Elijah Cummings (D-7) Fax: 202-225-3178
Rep. Chris Van Hollen (D-8) Fax: 202-225-0375
Massachusetts
Gov. Deval Patrick (D) Fax: 202-624-7714
State Legislature Links
Sen. Paul Kirk Jr (D) Fax: 202-224-2417
Sen. John Kerry (D) Fax: 202-224-8525
Rep. John Olver (D-1) Fax: 202-226-1224
Rep. Richard Neal (D-2) Fax: 202-225-8112
Rep. Jim McGovern (D-3) Fax: 202-225-5759
Rep. Barney Frank (D-4) Fax: 202-225-0182
Rep. Niki Tsongas (D-5) Fax: 202-226-0771
Rep. John Tierney (D-6) Fax: 202-225-5915
Rep. Edward Markey (D-7) Fax: 202-226-0092
Rep. Michael Capuano (D-8) Fax: 202-225-9322
Rep. Stephen Lynch (D-9) Fax: 202-225-3984
Rep. William Delahunt (D-10) Fax: 202-225-5658
Michigan
Gov. Jennifer Granholm (D) Fax:(517) 335-6863
State Legislature Links
Sen. Carl Levin (D) Fax: 202-224-1388
Sen. Debbie Stabenow (D) Fax: 202-228-0325
Rep. Bart Stupak (D-1) Fax: 202-225-4744
Rep. Peter Hoekstra (R-2) Fax: 202-226-0779
Rep. Vernon Ehlers (R-3) Fax: 202-225-5144
Rep. David Camp (R-4) Fax: 202-225-9679
Rep. Dale Kildee (D-5) Fax: 202-225-6393
Rep. Fred Upton (R-6) Fax: 202-225-4986
Rep. Mark Schauer (D-7) Fax: 202-225-6281
Rep. Mike Rogers (R-8) Fax: 202-225-5820
Rep. Gary Peters (D-9) Fax: 202-226-2356
Rep. Candice Miller (R-10) Fax: 202-226-1169
Rep. Thad McCotter (R-11) Fax: 202-225-2667
Rep. Sander Levin (D-12) Fax: 202-226-1033
Rep. Carolyn Kilpatrick (D-13) Fax: 202-225-5730
Rep. John Conyers (D-14) Fax: 202-225-0072
Rep. John Dingell (D-15) Fax: 202-226-0371
Minnesota
Gov. Tim Pawlenty (R) 651-296-3391
State Legislature Links
Sen. Amy Klobuchar (D) Fax: 202-228-2186
Sen. Al Franken (D) Fax: 202-224-1152
Rep. Tim Walz (D-1) Fax: 202-225-3433
Rep. John Kline (R-2) Fax: 202-225-2595
Rep. Erik Paulsen (R-3) Fax: 202-225-6351
Rep. Betty McCollum (D-4) Fax: 202-225-1968
Rep. Keith Ellison (D-5) Fax: 202-225-4886
Rep. Michelle Bachman (R-6) Fax: 202-225-6475
Rep. Collin Peterson (D-7) Fax: 202-225-1593
Rep. James Oberstar (D-8) Fax: 202-225-6211
Mississippi
Gov. Haley Barbour (R) 601-359-3150
State Legislature Links
Sen. Thad Cochran (R) Fax: 202-224-9450
Sen. Roger Wicker (R) Fax: 202-228-0378
Rep. Travis Childers (D-1) Fax: 662-844-5437
Rep. Bennie Thompson (D-2) Fax: 202-225-5898
Rep. Gregg Harper (R-3) Fax: 202-225-5797
Rep. Gene Taylor (D-4) Fax: 202-225-7074
Missouri
Gov. Jeremiah Nixon (D) 573-751-3222
State Legislature Links
Sen. Kit Bond (R) Fax: 202-224-8149
Sen. Claire McCaskill (D) Fax: 202-228-6326
Rep. William Clay, Jr. (D-1) Fax: 202-226-3717
Rep. Todd Akin (R-2) Fax: 202-225-2563
Rep. Russ Carnahan (D-3) Fax: 202-225-7452
Rep. Ike Skelton (D-4) Fax: 202-225-2876
Rep. Emanuel Cleaver (D-5) Fax: 202-225-4403
Rep. Sam Graves (R-6) Fax: 202-225-8221
Rep. Roy Blunt (R-7) Fax: 202-225-5604
Rep. Jo Ann Emerson (R-8) Fax: 202-226-0326
Rep. Blaine Luetkemeyer (R-9) Fax: 202-225-5712
Montana
Gov. Brian Schweitzer (D) 406-444-3111
State Legislature Links
Sen. Max Baucus (D) Fax: 202-224-9412
Sen. Jon Tester (D) Fax: 202-224-8594
Rep. Dennis Rehberg (R-At Large) Fax: 202-225-5687
Nebraska
Gov. Dave Heineman (R) Fax: 402-471-6031
State Legislature Links
Sen. Mike Johanns (R) Fax: 202-224-5213
Sen. Ben Nelson (D) Fax: 202-228-0012
Rep. Jeff Fortenberry (R-1) Fax: 202-225-5686
Rep. Lee Terry (R-2) Fax: 202-226-5452
Rep. Adrian Smith (R-3) Fax: 202-225-0207
Nevada
Gov. Jim Gibbons (R) 775-684-5670
State Legislature Links
Sen. John Ensign (R) Fax: 202-228-2193
Sen. Harry Reid (D) Fax: 202-224-7327
Rep. Shelley Berkley (D-1) Fax: 202-225-3119
Rep. Dean Heller (R-2) Fax: 202-225-5679
Rep. Dina Titus (D-3) Fax: 202-225-2185
New Hampshire
Gov. John Lynch (R) 603-271-7680
State Legislature Links
Sen. Judd Gregg (R) Fax: 202-224-4952
Sen. Jeanne Shaheen (D) Fax: 202-228-4131
Rep. Carol Shea-Porter (D-1) Fax: 202-225-5822
Rep. Paul Hodes (D-2) Fax: 202-225-2946
New Jersey
Gov. Jon Corzine (D) 609-292-6000
State Legislature Links
Sen. Robert Menendez (D) Fax: 202-228-2197
Sen. Frank Lautenberg (D) Fax: 202-228-4054
Rep. Robert Andrews (D-1) Fax: 202-225-6583
Rep. Frank LoBiondo (R-2) Fax: 202-225-3318
Rep. John Alder (D-3) Fax: 202-225-0778
Rep. Christopher Smith (R-4) Fax: 202-225-7768
Rep. Scott Garrett (R-5) Fax: 202-225-9048
Rep. Frank Pallone (D-6) Fax: 202-225-9665
Rep. Leonard Lance (R-7) Fax: 202-225-9460
Rep. William Pascrell (D-8) Fax: 202-225-5751
Rep. Steven Rothman (D-9) Fax: 202-225-5851
Rep. Donald Payne (D-10) Fax: 202-225-4160
Rep. Rodney Frelinghuysen (R-11) Fax: 202-225-3186
Rep. Rush Holt (D-12) Fax: 202-225-6025
Rep. Albio Sires (D-13) Fax: 202-226-0792
New Mexico
Gov. Bill Richardson (D) 505-476-2200
State Legislature Links
Sen. Jeff Bingaman (D) Fax: 202-224-2852
Sen. Tom Udall (D) Fax: 202-228-3261
Rep. Martin Heinrich (D-1) Fax: 202-225-4975
Rep. Harry Teague (D-2) Fax: 202-225-9599
Rep. Ben Lujan (D-3) Fax: 202-226-1528
New York
Gov. David Patterson (D) 518-474-8390
State Assembly Links
State Senate Links
Sen. Charles Schumer (D) Fax: 202-228-3027
Sen. Kirsten Gillibrand (D) Fax: 202-228-0282
Rep. Tim Bishop (D-1) Fax: 202-225-3143
Rep. Steven Israel (D-2) Fax: 202-225-4669
Rep. Peter King (R-3) Fax: 202-226-2279
Rep. Carolyn McCarthy (D-4) Fax: 202-225-5758
Rep. Gary Ackerman (D-5) Fax: 202-225-1589
Rep. Gregory Meeks (D-6) Fax: 202-226-4169
Rep. Joseph Crowley (D-7) Fax: 202-225-1909
Rep. Jerrold Nadler (D-8) Fax: 202-225-6923
Rep. Anthony Weiner (D-9) Fax: 202-226-7243
Rep. Edolphus Towns (D-10) Fax: 202-225-1018
Rep. Yvette Clarke (D-11) Fax: 202-226-0112
Rep. Nydia Velazquez (D-12) Fax: 202-226-0327
Rep. Michael McMahon (D-13) Fax: 202-225-1272
Rep. Carolyn Maloney (D-14) Fax: 202-225-4709 Non-constituents
Rep. Charles Rangel (D-15) Fax: 202-226-0816
Rep. Jose Serrano (D-16) Fax: 202-225-6001
Rep. Eliot Engel (D-17) Fax: 202-225-5513
Rep. Nita Lowey (D-18) Fax: 202-225-0546
Rep. John Hall (D-19) Fax: 202-225-3289
Rep. Scott Murphy (D-20) Fax: 202-225-1168
Rep. Paul Tonko (D-21) Fax: 202-225-5077
Rep. Maurice Hinchey (D-22) Fax: 202-226-0774
Rep. John McHugh (R-23) Fax: 202-226-0621
Rep. Michael Arcuri (D-24) Fax: 202-225-1891
Rep. Dan Maffei (D-25) Fax: 202-225-4042
Rep. Christopher Lee (R-26) Fax: 202-225-5910
Rep. Brian Higgins (D-27) Fax: 202-226-0347
Rep. Louise Slaughter (D-28) Fax: 202-225-7822
Rep. Eric Massa (D-29) Fax: 202-226-6599
North Carolina
Gov. Bev Purdue (D) 919-733-4240
State Legislature Links
Sen. Richard Burr (R) Fax 202-228-2981
Sen. Kay Hagan (D) Fax: 202-224-1100
Rep. G.K. Butterfield (D-1) Fax: 202-225-3354
Rep. Bob Etheridge (D-2) Fax: 202-225-5662
Rep. Walter Jones (R-3) Fax: 202-225-3286
Rep. David Price (D-4) Fax: 202-225-2014
Rep. Virginia Foxx (R-5) Fax: 202-225-2995
Rep. Howard Coble (R-6) Fax: 202-225-8611
Rep. Mike McIntyre (D-7) Fax: 202-225-5773
Rep. Larry Kissel (D-8) Fax: 202-225-4036
Rep. Sue Myrick (R-9) Fax: 202-225-3389
Rep. Patrick McHenry (R-10) Fax: 202-225-0316
Rep. Heath Shuler (D-11) Fax: 202-226-6422
Rep. Melvin Watt (D-12) Fax: 202-225-1512
Rep. Brad Miller (D-13) Fax: 202-225-0181
North Dakota
Gov. John Hoeven (R) 701-328-2200
State Legislature Links
Sen. Kent Conrad (D) Fax: 202-224-7776
Sen. Byron L. Dorgan (D) Fax: 202-224-1193
Rep. Earl Pomeroy (D-At Large) Fax: 202-226-0893
Ohio
Gov. Ted Strickland (D) 614-466-3555
State Legislature Links
Sen. Sherrod Brown (D) Fax: 202-224-6519
Sen. George Voinovich (R) Fax: 202-228-1382
Rep. Steve Chabot (R-1) Fax: 202-225-3012
Rep. Jean Schmidt (R-2) Fax: 202-225-1992
Rep. Michael Turner (R-3) Fax: 202-226-1443
Rep. Jim Jordan (R-4) Fax: 202-226-0577
Rep. Bob Latta (R-5) Fax: 202-225-1985
Rep. Charlie Wilson (D-6) Fax: 202-225-5907
Rep. David Hobson (R-7) Fax: 202-225-1984
Rep. John Boehner (R-8) Fax: 202-225-0704
Rep. Marcy Kaptur (D-9) Fax: 202-225-7711
Rep. Dennis Kucinich (D-10) Fax: 202-225-5745
Rep. Marcia Fudge (D-11) Fax: 202-225-1339
Rep. Pat Tiberi (R-12) Fax: 202-226-4523
Rep. Betty Sutton (D-13) Fax: 202-225-2266
Rep. Steven LaTourette (R-14) Fax: 202-225-3307
Rep. Deborah Pryce (R-15) Fax: 202-225-3529
Rep. Ralph Regula (R-16) Fax: 202-225-3059
Rep. Tim Ryan (D-17) Fax: 202-225-3719
Rep. Zack Space (D-18) Fax: 202-225-3394
Oklahoma
Gov. Brad Henry (D) Fax: 405-521-3353
State Legislature Links
Sen. James Inhofe (R) Fax: 202-228-0380
Sen. Tom Coburn (R) Fax: 202-224-6008
Rep. John Sullivan (R-1) Fax: 202 225-9187
Rep. Dan Boren (D-2) Fax: 202-225-3038
Rep. Frank Lucas (R-3) Fax: 202-225-8698
Rep. Tom Cole (R-4) Fax: 202-225-3512
Rep. Mary Fallin (R-5) Fax: 202-226-1463
Oregon
Gov. Ted Kulongoski (D) 503-378-4582
State Legislature Links
Sen. Jeff Merkley (D) Fax: 202-228-3997
Sen. Ron Wyden (D) Fax: 202-228-2717
Rep. David Wu (D-1) Fax: 202-225-9497
Rep. Greg Walden (R-2) Fax: 202-225-5774
Rep. Earl Blumenauer (D-3) Fax: 202-225-8941
Rep. Peter DeFazio (D-4) Fax: 202-225-0032
Rep. Darlene Hooley (D-5) Fax: 202-225-5699
Pennsylvania
Gov. Ed Rendell (D) 717-787-2500
State Legislature Links
Sen. Robert Casey, Jr. (D) Fax: 202-228-0604
Sen. Arlen Specter (D) Fax: 202-228-1229
Rep. Robert Brady (D-1) Fax: 202-225-0088
Rep. Chaka Fattah (D-2) Fax: 202-225-5392
Rep. Kathy Dahlkemper (D-3) Fax: 202-225-3103
Rep. Jason Altmire (D-4) Fax: 202-226-2274
Rep. John Peterson (R-5) Fax: 202-225-5796
Rep. Jim Gerlach (R-6) Fax: 202-225-8440
Rep. Joe Sestak (D-7) Fax: 202-225-0280
Rep. Patrick Murphy (D-8) Fax: 202-225-9511
Rep. Bill Shuster (R-9) Fax: 202-225-2486
Rep. Chris Carney (D-10) Fax: 202-225-9594
Rep. Paul Kanjorski (D-11) Fax: 202-225-0764
Rep. John Murtha (D-12) Fax: 202-225-5709
Rep. Allyson Schwartz (D-13) Fax: 202-226-0611
Rep. Michael Doyle (D-14) Fax: 202-225-3084
Rep. Charlie Dent (R-15) Fax: 202-226-0778
Rep. Joseph Pitts (R-16) Fax: 202-225-2013
Rep. Tim Holden (D-17) Fax: 202-226-0996
Rep. Tim Murphy (R-18) Fax: 202-225-1844
Rep. Todd Platts (R-19) Fax: 202-226-1000
Rhode Island
Gov. Don Carcieri (R) 401-222-2080
State Legislature Links
Sen. Sheldon Whitehouse (D) Fax: 202-228-2853
Sen. Jack Reed (D) Fax: 202-224-4680
Rep. Patrick Kennedy (D-1) Fax: 202-225-3290
Rep. James Langevin (D-2) Fax: 202-225-5976
South Carolina
Gov. Mark Sanford (R) 803-734-2100
State Legislature Links
Sen. Jim DeMint (R) Fax: 202-228-5143
Sen. Lindsey Graham (R) Fax: 202-224-3808
Rep. Henry Brown (R-1) Fax: 202-225-3407
Rep. Joe Wilson (R-2) Fax: 202-225-2455
Rep. Gresham Barrett (R-3) Fax: 202-225-3216
Rep. Bob Inglis (R-4) Fax: 202-226-1177
Rep. John Spratt (D-5) Fax: 202-225-0464
Rep. James Clyburn (D-6) Fax: 202-225-2313
South Dakota
Gov. Mike Rounds (R) 605-773-3212
State Legislature Links
Sen. John Thune (R) Fax: 202-228-5429
Sen. Tim Johnson (D) Fax: 202-228-5765
Rep. Stephanie Herseth (D-At Large) Fax: 202-225-5823
Tennessee
Gov. Phil Bredesen (D) 615-741-2001
State Legislature Links
Sen. Bob Corker (R) Fax: 202-228-1264
Sen. Lamar Alexander (R) Fax: 202-228-3398
Rep. Phil Roe (R-1) Fax: 202-225-5714
Rep. John Duncan, Jr. (R-2) Fax: 202-225-6440
Rep. Zach Wamp (R-3) Fax: 202-225-3494
Rep. Lincoln Davis (D-4) Fax: 202-226-5172
Rep. Jim Cooper (D-5) Fax: 202-226-1035
Rep. Bart Gordon (D-6) Fax: 202-225-6887
Rep. Marsha Blackburn (R-7) Fax: 202-225-3004
Rep. John Tanner (D-8) Fax: 202-225-1765
Rep. Steve Cohen (D-9) Fax: 202-225-5663
Texas
Gov. Rick Perry (R) 512-463-2000
State Legislature Links
Sen. John Cornyn (R) Fax: 202-228-2856
Sen. Kay Bailey Hutchison (R) Fax: 202-224-0776
Rep. Louis Gohmert (R-1) Fax: 202-225-5866
Rep. Ted Poe (R-2) Fax: 202-225-5547
Rep. Sam Johnson (R-3) Fax: 202-225-1485
Rep. Ralph Hall (R-4) Fax: 202-225-3332
Rep. Jeb Hensarling (R-5) Fax: 202-226-4888
Rep. Joe Barton (R-6) Fax: 202-225-3052
Rep. John Culberson (R-7) Fax: 202-225-4381
Rep. Kevin Brady (R-8) Fax: 202-225-5524
Rep. Al Green (D-9) Fax: 202-225-2947
Rep. Michael McCaul (R-10) Fax: 202-225-5955
Rep. Mike Conaway (R-11) Fax: 202-225-1783
Rep. Kay Granger (R-12) Fax: 202-225-5683
Rep. "Mac" Thornberry (R-13) Fax: 202-225-3486
Rep. Ron Paul (R-14) Fax: 202-226-6553
Rep. Ruben Hinojosa (D-15) Fax: 202-225-5688
Rep. Silvestre Reyes (D-16) Fax: 202-225-2016
Rep. Chet Edwards (D-17) Fax: 202-225-2234
Rep. Sheila Jackson-Lee (D-18) Fax: 202-225-3317
Rep. Randy Neugebauer (R-19) Fax: 202-225-9615
Rep. Charles Gonzalez (D-20) Fax: 202-225-1915
Rep. Lamar Smith (R-21) Fax: 202-225-8628
Rep. Pete Olson (R-22) Fax: 202-225-5241
Rep. Ciro Rodriguez (D-23) Fax: 202-225-2237
Rep. Kenny Marchant (R-24) Fax: 202-225-0074
Rep. Lloyd Doggett (D-25) Fax: 202-225-2947
Rep. Michael Burgess (R-26) Fax: 202-225-2919
Rep. Solomon Ortiz (D-27) Fax: 202-226-1134
Rep. Enrique Cuellar (D-28) Fax: 202-225-1641
Rep. Gene Green (D-29) Fax: 202-225-9903
Rep. Eddie Bernice Johnson (D-30) Fax: 202-226-1477
Rep. John Carter (R-31) Fax: 202-225-5886
Rep. Pete Sessions (R-32) Fax: 202-225-5878
Utah
Gov. Jon Huntsman, Jr. (R) 801-538-1000
State Legislature Links
Sen. Robert F. Bennett (R) Fax: 202-228-1168
Sen. Orrin G. Hatch (R) Fax: 202-224-6331
Rep. Rob Bishop (R-1) Fax: 202-225-5857
Rep. Jim Matheson (D-2) Fax: 202-225-5638
Rep. Chris Cannon (R-3) Fax: 202-225-5629
Vermont
Gov. Jim Douglas (R) 802-828-3333
State Legislature Links
Sen. Bernie Sanders (I) Fax: 202-228-0776
Sen. Patrick J. Leahy (D) Fax: 202-224-3479
Rep. Peter Welch (D-At Large) Fax: 202-225-6790
Virginia
Gov. Tim Kaine (D) 804-786-2211
State Legislature Links
Sen. Jim Webb (D) Fax: 202-228-6363
Sen. Mark Warner (D) Fax: 202-224-6295
Rep. Robert Wittman (R-1) Fax: 202-225-4382
Rep. Glen Nye (D-2) Fax: 202-225-4218
Rep. Robert Scott (D-3) Fax: 202-225-8354
Rep. Randy Forbes (R-4) Fax: 202-226-1170
Rep. Thomas Perriello (D-5) Fax: 202-225-5681
Rep. Bob Goodlatte (R-6) Fax: 202-225-9681
Rep. Eric Cantor (R-7) Fax: 202-225-0011
Rep. Jim Moran (D-8) Fax: 202-225-0017
Rep. Rick Boucher (D-9) Fax: 202-225-0442
Rep. Frank Wolf (R-10) Fax: 202-225-0437
Rep. Gerald Connolly (D-11) Fax: 202-225-3071
Washington
Gov. Christine Gregoire (D) 360-902-4111
State Legislature Links
Sen. Maria Cantwell (D) Fax: 202-228-0514
Sen. Patty Murray (D) Fax: 202-224-0238
Rep. Jay Inslee (D-1) Fax: 202-226-1606
Rep. Rick Larsen (D-2) Fax: 202-225-4420
Rep. Brian Baird (D-3) Fax: 202-225-3478
Rep. Doc Hastings (R-4) Fax: 202-225-3251
Rep. Cathy McMorris (R-5) Fax: 202-225-3392
Rep. Norman Dicks (D-6) Fax: 202-226-1176
Rep. Jim McDermott (D-7) Fax: 202-225-6197
Rep. Dave Reichert (R-8) Fax: 202-225-4282
Rep. Adam Smith (D-9) Fax: 202-225-5893
West Virginia
Gov. Joe Manchin III (D) 888-438-2731
State Legislature Links
Sen. Robert C. Byrd (D) Fax: 202-228-0002
Sen. John D. Rockefeller, IV (D) Fax: 202-224-7665
Rep. Alan Mollohan (D-1) Fax: 202-225-7564
Rep. Shelley Capito (R-2) Fax: 202-225-7856
Rep. Nick Rahall (D-3) Fax: 202-225-9061
Wisconsin
Gov. Jim Doyle (D) 608-266-1212
State Legislature Links
Sen. Russell D. Feingold (D) Fax: 202-224-2725
Sen. Herb Kohl (D) Fax: 202-224-9787
Rep. Paul Ryan (R-1) Fax: 202-225-3393
Rep. Tammy Baldwin (D-2) Fax: 202-225-6942
Rep. Ron Kind (D-3) Fax: 202-225-5739
Rep. Gwen Moore (D-4) Fax: 202-225-8135
Rep. James Sensenbrenner (R-5) Fax: 202-225-3190
Rep. Tom Petri (R-6) Fax: 202-225-2356
Rep. David Obey (D-7) Fax: 715-842-4488
Rep. Steve Kagan (D-8) Fax: 202-225-5729
Wyoming
Gov. Dave Freudenthal (D) 307-777-7434
State Legislature Links
Sen. Mike Enzi (R) Fax: 202-228-0359
Sen. John Barrasso (R) Fax: 202-224-1724
Rep. Barbara Cubin (R-At Large) Fax: 202-225-3057
Territories and Delegates:
American Samoa
Gov. Togiola Tulafono (D) 684-633-4116
Delegate Eni Faleomavaega (D-At Large) Fax: 202-225-8757
Washington, D.C.
DC City Council Links
Delegate Eleanor Holmes Norton (D-At Large) Fax 202-225-3002
Guam
Gov. Felix Camacho (R)
Territorial Legislature Links
Delegate Madeilene Bordallo (D-At Large) Fax: 202-226-0341
Northern Mariana Islands
Gov. Benigno Fital (Covenant) 670-664-1100
Territorial Legislature Links
Puerto Rico
Gov. Luis Fortuno (R) 787-721-7000
Territorial Legislature Links
Delegate Pedro Pierluisi (D-At Large) Fax: 202-225-2154
Virgin Islands
Gov. John de Jongh (D)
Territorial Legislature Links
Delegate Donna Christensen (D-At Large) Fax: 202-225-5517
Alabama
Gov. Bob Riley (R) 334-242-7100
State Legislature Links
Sen. Jeff Sessions (R) Fax: 202-224-3149
Sen. Richard C. Shelby (R) Fax: 202-224-3416
Rep. Jo Bonner (R-1) Fax: 202-225-0562
Rep. Bobby Bright (D-2) Fax: 202-225-8913
Rep. Michael Rogers (R-3) Fax: 202-226-8485
Rep. Robert Aderholt (R-4) Fax: 202-225-5587
Rep. Parker Griffith (D-5) Fax: 202-225-4392
Rep. Spencer Bachus (R-6) Fax: 202-225-2082
Rep. Artur Davis (D-7) Fax: 202-226-9567
Alaska
Gov. Sean Parnell (R) 907-465-3500
State Legislature Links
Sen. Lisa Murkowski (R) Fax: 202-224-5301
Sen. Mark Begich (D) Fax: 202-224-2354
Rep. Don Young (R-At Large) Fax: 202-225-0425
Arizona
Gov. Jan Brewer (R) 602-542-4331
State Legislature Links
Arizona Constitution
Sen. Jon Kyl. (R) Fax: 202-224-2207
Sen. John McCain (R) Fax: 202-228-2862
Rep. Ann Kirkpatrick (D-1) Fax: 202-226-9739
Rep. Trent Franks (R-2) Fax: 202-225-6328
Rep. John Shadegg (R-3) Fax: 202-225-3462
Rep. Ed Pastor (D-4) Fax: 202-225-1655
Rep. Harry Mitchell (D-5) Fax: 202-225-3263
Rep. Jeff Flake (R-6) Fax: 202-226-4386
Rep. Raul Grijalva (D-7) Fax: 202-225-1541
Rep. Gabrielle Giffords (D-8) Fax: 202-225-0378
Arkansas
Gov. Mike Beebe (D) 501-682-2345
State Legislature Links
Sen. Blanche Lincoln (D) Fax: 202-228-1371
Sen. Mark Pryor (D) Fax: 202-228-0908
Rep. Marion Berry (D-1) Fax: 202-225-5602
Rep. Vic Snyder (D-2) Fax: 202-225-5903
Rep. John Boozeman (R-3) Fax: 202-225-5713
Rep. Mike Ross (D-4) Fax: 202-225-1314
California
Gov. Arnold Schwarzenegger (R) Fax: 916-558-3160
State Legislature Links
Sen. Barbara Boxer (D) Fax: 415-956-6701
Sen. Dianne Feinstein (D) Fax: 202-228-3954
Rep. Mike Thompson (D-1) Fax: 202-225-4335
Rep. Wally Herger (R-2) Fax: 202-225-1740
Rep. Dan Lungren (R-3) Fax: 202-226-1298
Rep. Tom McClintock (R-4) Fax: 202-225-5444
Rep. Doris Matsui (D-5) Fax: 202-225-0566
Rep. Lynn Woolsey (D-6) Fax: 202-225-5163
Rep. George Miller (D-7) Fax: 202-225-5609
Rep. Nancy Pelosi (D-8) Fax: 202-225-8259
Non Constituent email address for Speaker Pelosi.
Rep. Barbara Lee (D-9) Fax: 202-225-9817
Vacant (-10) Fax: 202-225-5914
Rep. Jerry McNerney (D-11) Fax: 202-226-0861
Rep. Jackie Speier (D-12) Fax: 202-226-4183
Rep. Pete Stark (D-13) Fax: 202-226-3805
Rep. Anna Eshoo (D-14) Fax: 202-225-8890
Rep. Mike Honda (D-15) Fax: 202-225-2699
Rep. Zoe Lofgren (D-16) Fax: 202-225-3336
Rep. Sam Farr (D-17) Fax: 202-225-6791
Rep. Dennis Cardoza (D-18) Fax: 202-225-0819
Rep. George Radanovich (R-19) Fax: 202-225-3402
Rep. Jim Costa (D-20) Fax: 202-225-9308
Rep. Devin Nunes (R-21) Fax: 202-225-3404
Rep. Kevin McCarthy (R-22) Fax: 202-225-8798
Rep. Lois Capps (D-23) Fax: 202-225-5632
Rep. Elton Gallegly (R-24) Fax: 202-225-1100
Rep. Howard McKeon (R-25) Fax: 202-225-0683
Rep. David Dreier (R-26) Fax: 202-225-7018
Rep. Brad Sherman (D-27) Fax: 202-225-5879
Rep. Howard Berman (D-28) Fax: 202-225-3196
Rep. Adam Schiff (D-29) Fax: 202-225-5828
Rep. Henry Waxman (D-30) Fax: 202-225-4099
Rep. Xavier Becerra (D-31) Fax: 202-225-2202
Rep. Judy Chu (D-32) Fax: 202-225-5467
Rep. Diane Watson (D-33) Fax: 202-225-2422
Rep. Lucille Roybal-Allard (D-34) Fax: 202-226-0350
Rep. Maxine Waters (D-35) Fax: 202-225-7854
Rep. Jane Harman (D-36) Fax: 202-226-7290
Rep. Laura Richardson (D-37) Fax: 202-225-7926
Rep. Grace Napolitano (D-38) Fax: 202-225-0027
Rep. Linda Sanchez (D-39) Fax: 202-225-5859
Rep. Ed Royce (R-40) Fax: 202-226-0335
Rep. Jerry Lewis (R-41) Fax: 202-225-6498
Rep. Gary Miller (R-42) Fax: 202-226-6962
Rep. Joe Baca (D-43) Fax: 202-225-8671
Rep. Ken Calvert (R-44) Fax: 202-225-2004
Rep. Mary Bono (R-45) Fax: 202-225-2961
Rep. Dana Rohrabacher (R-46) Fax: 202-225-0145
Rep. Loretta Sanchez (D-47) Fax: 202-225-5859
Rep. John Campbell (R-48) Fax: 202-225-9177
Rep. Darrell Issa (R-49) Fax: 202-225-3303
Rep. Brian Bilbray (R-50) Fax: 202-225-2558
Rep. Bob Filner (D-51) Fax: 202-225-9073
Rep. Duncan Hunter (R-52) Fax: 202-225-0235
Rep. Susan Davis (D-53) Fax: 202-225-2948
Colorado
Gov. Bill Ritter (D) 303-866-2471
State Legislature Links
Sen. Mark Udall (D) Fax: 202-224-6471
Sen. Michael Bennet (D) Fax: 202-224-1933
Rep. Diana DeGette (D-1) Fax: 202-225-5657
Rep. Jared Polis (D-2) Fax: 202-226-7840
Rep. John Salazar (D-3) Fax: 202-226-9669
Rep. Betsy Markey (D-4) Fax: 202-225-5870
Rep. Doug Lamborn (R-5) Fax: 202-225-1942
Rep. Mike Coffman (R-6) Fax: 202-226-4623
Rep. Ed Perlmutter (D-7) Fax: 202-225-5278
Connecticut
Gov. Jodi Rell (R) 860-566-4840
State Legislature Links
Sen. Christopher Dodd (D) Fax: 202-224-1083
Sen. Joseph Lieberman (D) Fax: 202-224-9750
Rep. John Larson (D-1) Fax: 202-225-1031
Rep. Joe Courtney (D-2) Fax: 202-225-4977
Rep. Rosa DeLauro (D-3) Fax: 202-225-4890
Rep. Jim Himes (D-4) Fax: 202-225-9629
Rep. Chris Murphy (D-5) Fax: 202-225-4488
Delaware
Gov. Jack Markell (D) 302-739-4101
State Legislature Links
Sen. Edward Kaufman (D) Fax:
Sen. Tom Carper (D) Fax: 202-228-2190
Rep. Michael Castle (R-At Large) Fax: 202-225-2291
Florida
Gov. Charlie Crist (R) 850-488-4441
State Legislature Links
Sen. George LeMieux (R) Fax: 202-224-2237
Sen. Bill Nelson (D) Fax: 202-228-2183
Rep. Jeff Miller (R-1) Fax: 202-225-3414
Rep. F. Allen Boyd (D-2) Fax: 202-225-5615
Rep. Corrine Brown (D-3) Fax: 202-225-2256
Rep. Ander Crenshaw (R-4) Fax: 202-225-2504
Rep. Virginia Brown-Waite (R-5) Fax: 202-226-6559
Rep. Cliff Stearns (R-6) Fax: 202-225-3973
Rep. John Mica (R-7) Fax: 202-226-0821
Rep. Alan Grayson (D-8) Fax: 202-225-0999
Rep. Gus Bilirakis (R-9) Fax: 202-225-4085
Rep. Bill Young (R-10) Fax: 202-225-9764
Rep. Kathy Castor (D-11) Fax: 202-225-5652
Rep. Adam Putnam (R-12) Fax: 202-225-0585
Rep. Vern Buchanan (R-13) Fax: 202-226-0828
Rep. Connie Mack (R-14) Fax: 202-225-6820
Rep. Bill Posey (R-15) Fax: 202-225-3516
Rep. Tom Rooney (D-16) Fax: 202-225-3132
Rep. Kendrick Meek (D-17) Fax: 202-226-0777
Rep. Ileana Ros-Lehtinen (R-18) Fax: 202-225-5620
Rep. Robert Wexler (D-19) Fax: 202-225-5974
Rep. Debbie Wasserman Schultz (D-20) Fax: 202-225-8456
Rep. Lincoln Diaz-Balart (R-21) Fax: 202-225-8576
Rep. Ron Klein (D-22) Fax: 202-225-8398
Rep. Alcee Hastings (D-23) Fax: 202-225-1171
Rep. Suzanne Kosmas (D-24) Fax: 202-226-6299
Rep. Mario Diaz-Balart (R-25) Fax: 202-226-0346
Georgia
Gov. Sonny Perdue (R) 404-656-1776
State Legislature Links
Sen. Saxby Chamblis (R) Fax 202-224-0103
Sen. Johnny Isakson (R) Fax: 202-228-2090
Rep. Jack Kingston (R-1) Fax: 202-226-2269
Rep. Sanford Bishop (D-2) Fax: 202-225-2203
Rep. Lynn Westmoreland (R-3) Fax: 202-225-3013
Rep. Hank Johnson (D-4) Fax: 202-226-0691
Rep. John Lewis (D-5) Fax: 202-225-0351
Rep. Thomas Price (R-6) Fax: 202-225-4656
Rep. John Linder (R-7) Fax: 202-225-4696
Rep. Jim Marshall (D-8) Fax: 202-225-2515
Rep. Nathan Deal (R-9) Fax: 202-225-5995
Rep. Paul Broun (R-10) Fax: 202-225-8272
Rep. Phil Gingrey (R-11) Fax: 202-225-2944
Rep. John Barrow (D-12) Fax: 202-225-3377
Rep. David Scott (D-13) Fax: 202-225-4628
Hawaii
Gov. Linda Lingle (R) 808-586-0034
State Legislature Links
Sen. Daniel K. Akaka (D) Fax: 202-224-2126
Sen. Daniel K. Inouye (D) Fax: 202-224-6747
Rep. Neil Abercrombie (D-1) Fax: 202-225-4580
Rep. Mazie Hirono (D-2) Fax: 202-225-4987
Idaho
Gov. Butch Otter (R) 208-334-2100
State Legislature Links
Sen. James Risch (R) Fax: 202-228-1067
Sen. Michael Crapo (R) Fax: 202-228-1375
Rep. Walt Minnick (D-1) Fax: 202-225-3029
Rep. Michael Simpson (R-2) Fax: 202-225-8216
Illinois
Gov. Pat Quinn (D) 217-782-0244
State Legislature Links
Sen. Dick Durbin (D) Fax: 202-228-0400
Sen. Roland Burris (D) Fax: 202-228-5417
Rep. Bobby Rush (D-1) Fax: 202-226-0333
Rep. Jesse Jackson, Jr. (D-2) Fax: 202-225-0899
Rep. Daniel Lipinski (D-3) Fax: 202-225-1012
Rep. Luis Gutirrez (D-4) Fax: 202-225-7810
Rep. Mike Quigley (D-5) Fax: 202-225-5603
Rep. Peter Roskam (R-6) Fax: 202-225-1166
Rep. Danny Davis (D-7) Fax: 202-225-5641
Rep. Melissa Bean (D-8) Fax: 202-225-7830
Rep. Janice Schakowsky (D-9) Fax: 202-226-6890
Rep. Mark Kirk (R-10) Fax: 202-225-0837
Rep. Deborah Halvorson (D-11) Fax: 202-225-3521
Rep. Jerry Costello (D-12) Fax: 202-225-0285
Rep. Judy Biggert (R-13) Fax: 202-225-9420
Rep. Bill Foster (D-14) Fax: 202-225-0697
Rep. Timothy Johnson (R-15) Fax: 202-226-0791
Rep. Donald Manzullo (R-16) Fax: 202-225-5284
Rep. Philip Hare (D-17) Fax: 202-225-5396
Rep. Aaron Schock (R-18) Fax: 202-225-9249
Rep. John Shimkus (R-19) Fax: 202-225-5880
Indiana
Gov. Mitch Daniels (R) 317-232-4567
State Legislature Links
Sen. Evan Bayh (D) Fax: (202) 228-1377
Sen. Richard G. Lugar (R) Fax: 202-228-0360
Rep. Peter Visclosky (D-1) Fax: 202-225-2493
Rep. Joe Donnelly (D-2) Fax: 202-225-6798
Rep. Mark Souder (R-3) Fax: 202-225-3479
Rep. Stephen Buyer (R-4) Fax: 202-225-2267
Rep. Dan Burton (R-5) Fax: 202-225-0016
Rep. Mike Pence (R-6) Fax: 202-225-3382
Rep. André Carson (D-7) Fax: 202-225-5633
Rep. Brad Ellsworth (D-8) Fax: 202-225-3284
Rep. Baron Hill (D-9) Fax: 202-226-6866
Iowa
Gov. Chet Culver (D) 515-281-5211
State Legislature Links
Sen. Chuck Grassley (R) Fax: 202-224-6020
Sen. Tom Harkin (D) Fax: 202-224-9369
Rep. Bruce Braley (D-1) Fax: 202-225-9129
Rep. David Loebsack (D-2) Fax: 202-226-0757
Rep. Leonard Boswell (D-3) Fax: 202-225-5608
Rep. Tom Latham (R-4) Fax: 202-225-3301
Rep. Steve King (R-5) Fax: 202-225-3193
Kansas
Gov. Kathleen Sebelius (D) 785-296-3232
State Legislature Links
Sen. Sam Brownback (R) Fax: 202-228-1265
Sen. Pat Roberts (R) Fax: 202-224-3514
Rep. Jerry Moran (R-1) Fax: 202-225-5124
Rep. Lynn Jenkins (R-2) Fax: 202-225-7986
Rep. Dennis Moore (R-3) Fax: 202-225-2807
Rep. Todd Tiahrt (R-4) Fax: 202-225-3489
Kentucky
Gov. Steve Beshear (D) 502-564-2611
State Legislature Links
Sen. Jim Bunning (R) Fax: 202-228-1373
Sen. Mitch McConnell (R) Fax: 202-224-2499
Rep. Ed Whitfield (R-1) Fax: 202-225-3547
Rep. Brett Guthrie (R-2) Fax: 202-226-2019
Rep. John Yarmuth (D-3) Fax: 202-225-5776
Rep. Geoff Davis (R-4) Fax: 202-225-0003
Rep. Harold Rogers (R-5) Fax: 202-225-0940
Rep. Ben Chandler (D-6) Fax: 202-225-2122
Louisiana
Gov. Bobby Jindal (R) 225-342-0991
State Legislature Links
Sen. Mary Landrieu (D) Fax: 202-224-9735
Sen. David Vitter (R) Fax: 202-228-2577
Rep. Steve Scalise (R-1) Fax: (202) 226-0386
Rep. Joseph Cao (R-2) Fax: 202-225-1988
Rep. Charlie Melancon (D-3) Fax: (202) 226-3944
Rep. John Fleming (R-4) Fax: 202-225-8039
Rep. Rodney Alexander (D-5) Fax: 202-225-5639
Rep. Bill Cassidy (R-6) Fax: 202-225-7313
Rep. Charles Boustany (R-7) Fax: 202-225-5724
Maine
Gov. John Baldacci (D) 207-287-1034
State Legislature Links
Sen. Susan Collins (R) Fax: 202-224-2693
Sen. Olympia Snowe (R) Fax: 202-224-1946
Rep. Tom Allen (D-1) Fax: 202-225-5590
Rep. Michael Michaud (D-2) Fax: 202-225-2943
Maryland
Gov. Martin O'Malley (D) 800-811-8336
State Legislature Links
Sen. Benjamin Cardin (D) Fax: 202-224-1651
Sen. Barbara Mikulski (D) Fax: 202-224-8858
Rep. Wayne Gilchrest (R-1) Fax: 202-225-0254
Rep. "Dutch" Ruppersberger (D-2) Fax: 202-225-3094
Rep. John Sarbanes (D-3) Fax: 202-225-9219
Rep. Donna Edwards (D-4) Fax: 202-225-8714
Rep. Steny Hoyer (D-5) Fax: 202-225-4300
Rep. Roscoe Bartlett (R-6) Fax: 202-225-2193
Rep. Elijah Cummings (D-7) Fax: 202-225-3178
Rep. Chris Van Hollen (D-8) Fax: 202-225-0375
Massachusetts
Gov. Deval Patrick (D) Fax: 202-624-7714
State Legislature Links
Sen. Paul Kirk Jr (D) Fax: 202-224-2417
Sen. John Kerry (D) Fax: 202-224-8525
Rep. John Olver (D-1) Fax: 202-226-1224
Rep. Richard Neal (D-2) Fax: 202-225-8112
Rep. Jim McGovern (D-3) Fax: 202-225-5759
Rep. Barney Frank (D-4) Fax: 202-225-0182
Rep. Niki Tsongas (D-5) Fax: 202-226-0771
Rep. John Tierney (D-6) Fax: 202-225-5915
Rep. Edward Markey (D-7) Fax: 202-226-0092
Rep. Michael Capuano (D-8) Fax: 202-225-9322
Rep. Stephen Lynch (D-9) Fax: 202-225-3984
Rep. William Delahunt (D-10) Fax: 202-225-5658
Michigan
Gov. Jennifer Granholm (D) Fax:(517) 335-6863
State Legislature Links
Sen. Carl Levin (D) Fax: 202-224-1388
Sen. Debbie Stabenow (D) Fax: 202-228-0325
Rep. Bart Stupak (D-1) Fax: 202-225-4744
Rep. Peter Hoekstra (R-2) Fax: 202-226-0779
Rep. Vernon Ehlers (R-3) Fax: 202-225-5144
Rep. David Camp (R-4) Fax: 202-225-9679
Rep. Dale Kildee (D-5) Fax: 202-225-6393
Rep. Fred Upton (R-6) Fax: 202-225-4986
Rep. Mark Schauer (D-7) Fax: 202-225-6281
Rep. Mike Rogers (R-8) Fax: 202-225-5820
Rep. Gary Peters (D-9) Fax: 202-226-2356
Rep. Candice Miller (R-10) Fax: 202-226-1169
Rep. Thad McCotter (R-11) Fax: 202-225-2667
Rep. Sander Levin (D-12) Fax: 202-226-1033
Rep. Carolyn Kilpatrick (D-13) Fax: 202-225-5730
Rep. John Conyers (D-14) Fax: 202-225-0072
Rep. John Dingell (D-15) Fax: 202-226-0371
Minnesota
Gov. Tim Pawlenty (R) 651-296-3391
State Legislature Links
Sen. Amy Klobuchar (D) Fax: 202-228-2186
Sen. Al Franken (D) Fax: 202-224-1152
Rep. Tim Walz (D-1) Fax: 202-225-3433
Rep. John Kline (R-2) Fax: 202-225-2595
Rep. Erik Paulsen (R-3) Fax: 202-225-6351
Rep. Betty McCollum (D-4) Fax: 202-225-1968
Rep. Keith Ellison (D-5) Fax: 202-225-4886
Rep. Michelle Bachman (R-6) Fax: 202-225-6475
Rep. Collin Peterson (D-7) Fax: 202-225-1593
Rep. James Oberstar (D-8) Fax: 202-225-6211
Mississippi
Gov. Haley Barbour (R) 601-359-3150
State Legislature Links
Sen. Thad Cochran (R) Fax: 202-224-9450
Sen. Roger Wicker (R) Fax: 202-228-0378
Rep. Travis Childers (D-1) Fax: 662-844-5437
Rep. Bennie Thompson (D-2) Fax: 202-225-5898
Rep. Gregg Harper (R-3) Fax: 202-225-5797
Rep. Gene Taylor (D-4) Fax: 202-225-7074
Missouri
Gov. Jeremiah Nixon (D) 573-751-3222
State Legislature Links
Sen. Kit Bond (R) Fax: 202-224-8149
Sen. Claire McCaskill (D) Fax: 202-228-6326
Rep. William Clay, Jr. (D-1) Fax: 202-226-3717
Rep. Todd Akin (R-2) Fax: 202-225-2563
Rep. Russ Carnahan (D-3) Fax: 202-225-7452
Rep. Ike Skelton (D-4) Fax: 202-225-2876
Rep. Emanuel Cleaver (D-5) Fax: 202-225-4403
Rep. Sam Graves (R-6) Fax: 202-225-8221
Rep. Roy Blunt (R-7) Fax: 202-225-5604
Rep. Jo Ann Emerson (R-8) Fax: 202-226-0326
Rep. Blaine Luetkemeyer (R-9) Fax: 202-225-5712
Montana
Gov. Brian Schweitzer (D) 406-444-3111
State Legislature Links
Sen. Max Baucus (D) Fax: 202-224-9412
Sen. Jon Tester (D) Fax: 202-224-8594
Rep. Dennis Rehberg (R-At Large) Fax: 202-225-5687
Nebraska
Gov. Dave Heineman (R) Fax: 402-471-6031
State Legislature Links
Sen. Mike Johanns (R) Fax: 202-224-5213
Sen. Ben Nelson (D) Fax: 202-228-0012
Rep. Jeff Fortenberry (R-1) Fax: 202-225-5686
Rep. Lee Terry (R-2) Fax: 202-226-5452
Rep. Adrian Smith (R-3) Fax: 202-225-0207
Nevada
Gov. Jim Gibbons (R) 775-684-5670
State Legislature Links
Sen. John Ensign (R) Fax: 202-228-2193
Sen. Harry Reid (D) Fax: 202-224-7327
Rep. Shelley Berkley (D-1) Fax: 202-225-3119
Rep. Dean Heller (R-2) Fax: 202-225-5679
Rep. Dina Titus (D-3) Fax: 202-225-2185
New Hampshire
Gov. John Lynch (R) 603-271-7680
State Legislature Links
Sen. Judd Gregg (R) Fax: 202-224-4952
Sen. Jeanne Shaheen (D) Fax: 202-228-4131
Rep. Carol Shea-Porter (D-1) Fax: 202-225-5822
Rep. Paul Hodes (D-2) Fax: 202-225-2946
New Jersey
Gov. Jon Corzine (D) 609-292-6000
State Legislature Links
Sen. Robert Menendez (D) Fax: 202-228-2197
Sen. Frank Lautenberg (D) Fax: 202-228-4054
Rep. Robert Andrews (D-1) Fax: 202-225-6583
Rep. Frank LoBiondo (R-2) Fax: 202-225-3318
Rep. John Alder (D-3) Fax: 202-225-0778
Rep. Christopher Smith (R-4) Fax: 202-225-7768
Rep. Scott Garrett (R-5) Fax: 202-225-9048
Rep. Frank Pallone (D-6) Fax: 202-225-9665
Rep. Leonard Lance (R-7) Fax: 202-225-9460
Rep. William Pascrell (D-8) Fax: 202-225-5751
Rep. Steven Rothman (D-9) Fax: 202-225-5851
Rep. Donald Payne (D-10) Fax: 202-225-4160
Rep. Rodney Frelinghuysen (R-11) Fax: 202-225-3186
Rep. Rush Holt (D-12) Fax: 202-225-6025
Rep. Albio Sires (D-13) Fax: 202-226-0792
New Mexico
Gov. Bill Richardson (D) 505-476-2200
State Legislature Links
Sen. Jeff Bingaman (D) Fax: 202-224-2852
Sen. Tom Udall (D) Fax: 202-228-3261
Rep. Martin Heinrich (D-1) Fax: 202-225-4975
Rep. Harry Teague (D-2) Fax: 202-225-9599
Rep. Ben Lujan (D-3) Fax: 202-226-1528
New York
Gov. David Patterson (D) 518-474-8390
State Assembly Links
State Senate Links
Sen. Charles Schumer (D) Fax: 202-228-3027
Sen. Kirsten Gillibrand (D) Fax: 202-228-0282
Rep. Tim Bishop (D-1) Fax: 202-225-3143
Rep. Steven Israel (D-2) Fax: 202-225-4669
Rep. Peter King (R-3) Fax: 202-226-2279
Rep. Carolyn McCarthy (D-4) Fax: 202-225-5758
Rep. Gary Ackerman (D-5) Fax: 202-225-1589
Rep. Gregory Meeks (D-6) Fax: 202-226-4169
Rep. Joseph Crowley (D-7) Fax: 202-225-1909
Rep. Jerrold Nadler (D-8) Fax: 202-225-6923
Rep. Anthony Weiner (D-9) Fax: 202-226-7243
Rep. Edolphus Towns (D-10) Fax: 202-225-1018
Rep. Yvette Clarke (D-11) Fax: 202-226-0112
Rep. Nydia Velazquez (D-12) Fax: 202-226-0327
Rep. Michael McMahon (D-13) Fax: 202-225-1272
Rep. Carolyn Maloney (D-14) Fax: 202-225-4709 Non-constituents
Rep. Charles Rangel (D-15) Fax: 202-226-0816
Rep. Jose Serrano (D-16) Fax: 202-225-6001
Rep. Eliot Engel (D-17) Fax: 202-225-5513
Rep. Nita Lowey (D-18) Fax: 202-225-0546
Rep. John Hall (D-19) Fax: 202-225-3289
Rep. Scott Murphy (D-20) Fax: 202-225-1168
Rep. Paul Tonko (D-21) Fax: 202-225-5077
Rep. Maurice Hinchey (D-22) Fax: 202-226-0774
Rep. John McHugh (R-23) Fax: 202-226-0621
Rep. Michael Arcuri (D-24) Fax: 202-225-1891
Rep. Dan Maffei (D-25) Fax: 202-225-4042
Rep. Christopher Lee (R-26) Fax: 202-225-5910
Rep. Brian Higgins (D-27) Fax: 202-226-0347
Rep. Louise Slaughter (D-28) Fax: 202-225-7822
Rep. Eric Massa (D-29) Fax: 202-226-6599
North Carolina
Gov. Bev Purdue (D) 919-733-4240
State Legislature Links
Sen. Richard Burr (R) Fax 202-228-2981
Sen. Kay Hagan (D) Fax: 202-224-1100
Rep. G.K. Butterfield (D-1) Fax: 202-225-3354
Rep. Bob Etheridge (D-2) Fax: 202-225-5662
Rep. Walter Jones (R-3) Fax: 202-225-3286
Rep. David Price (D-4) Fax: 202-225-2014
Rep. Virginia Foxx (R-5) Fax: 202-225-2995
Rep. Howard Coble (R-6) Fax: 202-225-8611
Rep. Mike McIntyre (D-7) Fax: 202-225-5773
Rep. Larry Kissel (D-8) Fax: 202-225-4036
Rep. Sue Myrick (R-9) Fax: 202-225-3389
Rep. Patrick McHenry (R-10) Fax: 202-225-0316
Rep. Heath Shuler (D-11) Fax: 202-226-6422
Rep. Melvin Watt (D-12) Fax: 202-225-1512
Rep. Brad Miller (D-13) Fax: 202-225-0181
North Dakota
Gov. John Hoeven (R) 701-328-2200
State Legislature Links
Sen. Kent Conrad (D) Fax: 202-224-7776
Sen. Byron L. Dorgan (D) Fax: 202-224-1193
Rep. Earl Pomeroy (D-At Large) Fax: 202-226-0893
Ohio
Gov. Ted Strickland (D) 614-466-3555
State Legislature Links
Sen. Sherrod Brown (D) Fax: 202-224-6519
Sen. George Voinovich (R) Fax: 202-228-1382
Rep. Steve Chabot (R-1) Fax: 202-225-3012
Rep. Jean Schmidt (R-2) Fax: 202-225-1992
Rep. Michael Turner (R-3) Fax: 202-226-1443
Rep. Jim Jordan (R-4) Fax: 202-226-0577
Rep. Bob Latta (R-5) Fax: 202-225-1985
Rep. Charlie Wilson (D-6) Fax: 202-225-5907
Rep. David Hobson (R-7) Fax: 202-225-1984
Rep. John Boehner (R-8) Fax: 202-225-0704
Rep. Marcy Kaptur (D-9) Fax: 202-225-7711
Rep. Dennis Kucinich (D-10) Fax: 202-225-5745
Rep. Marcia Fudge (D-11) Fax: 202-225-1339
Rep. Pat Tiberi (R-12) Fax: 202-226-4523
Rep. Betty Sutton (D-13) Fax: 202-225-2266
Rep. Steven LaTourette (R-14) Fax: 202-225-3307
Rep. Deborah Pryce (R-15) Fax: 202-225-3529
Rep. Ralph Regula (R-16) Fax: 202-225-3059
Rep. Tim Ryan (D-17) Fax: 202-225-3719
Rep. Zack Space (D-18) Fax: 202-225-3394
Oklahoma
Gov. Brad Henry (D) Fax: 405-521-3353
State Legislature Links
Sen. James Inhofe (R) Fax: 202-228-0380
Sen. Tom Coburn (R) Fax: 202-224-6008
Rep. John Sullivan (R-1) Fax: 202 225-9187
Rep. Dan Boren (D-2) Fax: 202-225-3038
Rep. Frank Lucas (R-3) Fax: 202-225-8698
Rep. Tom Cole (R-4) Fax: 202-225-3512
Rep. Mary Fallin (R-5) Fax: 202-226-1463
Oregon
Gov. Ted Kulongoski (D) 503-378-4582
State Legislature Links
Sen. Jeff Merkley (D) Fax: 202-228-3997
Sen. Ron Wyden (D) Fax: 202-228-2717
Rep. David Wu (D-1) Fax: 202-225-9497
Rep. Greg Walden (R-2) Fax: 202-225-5774
Rep. Earl Blumenauer (D-3) Fax: 202-225-8941
Rep. Peter DeFazio (D-4) Fax: 202-225-0032
Rep. Darlene Hooley (D-5) Fax: 202-225-5699
Pennsylvania
Gov. Ed Rendell (D) 717-787-2500
State Legislature Links
Sen. Robert Casey, Jr. (D) Fax: 202-228-0604
Sen. Arlen Specter (D) Fax: 202-228-1229
Rep. Robert Brady (D-1) Fax: 202-225-0088
Rep. Chaka Fattah (D-2) Fax: 202-225-5392
Rep. Kathy Dahlkemper (D-3) Fax: 202-225-3103
Rep. Jason Altmire (D-4) Fax: 202-226-2274
Rep. John Peterson (R-5) Fax: 202-225-5796
Rep. Jim Gerlach (R-6) Fax: 202-225-8440
Rep. Joe Sestak (D-7) Fax: 202-225-0280
Rep. Patrick Murphy (D-8) Fax: 202-225-9511
Rep. Bill Shuster (R-9) Fax: 202-225-2486
Rep. Chris Carney (D-10) Fax: 202-225-9594
Rep. Paul Kanjorski (D-11) Fax: 202-225-0764
Rep. John Murtha (D-12) Fax: 202-225-5709
Rep. Allyson Schwartz (D-13) Fax: 202-226-0611
Rep. Michael Doyle (D-14) Fax: 202-225-3084
Rep. Charlie Dent (R-15) Fax: 202-226-0778
Rep. Joseph Pitts (R-16) Fax: 202-225-2013
Rep. Tim Holden (D-17) Fax: 202-226-0996
Rep. Tim Murphy (R-18) Fax: 202-225-1844
Rep. Todd Platts (R-19) Fax: 202-226-1000
Rhode Island
Gov. Don Carcieri (R) 401-222-2080
State Legislature Links
Sen. Sheldon Whitehouse (D) Fax: 202-228-2853
Sen. Jack Reed (D) Fax: 202-224-4680
Rep. Patrick Kennedy (D-1) Fax: 202-225-3290
Rep. James Langevin (D-2) Fax: 202-225-5976
South Carolina
Gov. Mark Sanford (R) 803-734-2100
State Legislature Links
Sen. Jim DeMint (R) Fax: 202-228-5143
Sen. Lindsey Graham (R) Fax: 202-224-3808
Rep. Henry Brown (R-1) Fax: 202-225-3407
Rep. Joe Wilson (R-2) Fax: 202-225-2455
Rep. Gresham Barrett (R-3) Fax: 202-225-3216
Rep. Bob Inglis (R-4) Fax: 202-226-1177
Rep. John Spratt (D-5) Fax: 202-225-0464
Rep. James Clyburn (D-6) Fax: 202-225-2313
South Dakota
Gov. Mike Rounds (R) 605-773-3212
State Legislature Links
Sen. John Thune (R) Fax: 202-228-5429
Sen. Tim Johnson (D) Fax: 202-228-5765
Rep. Stephanie Herseth (D-At Large) Fax: 202-225-5823
Tennessee
Gov. Phil Bredesen (D) 615-741-2001
State Legislature Links
Sen. Bob Corker (R) Fax: 202-228-1264
Sen. Lamar Alexander (R) Fax: 202-228-3398
Rep. Phil Roe (R-1) Fax: 202-225-5714
Rep. John Duncan, Jr. (R-2) Fax: 202-225-6440
Rep. Zach Wamp (R-3) Fax: 202-225-3494
Rep. Lincoln Davis (D-4) Fax: 202-226-5172
Rep. Jim Cooper (D-5) Fax: 202-226-1035
Rep. Bart Gordon (D-6) Fax: 202-225-6887
Rep. Marsha Blackburn (R-7) Fax: 202-225-3004
Rep. John Tanner (D-8) Fax: 202-225-1765
Rep. Steve Cohen (D-9) Fax: 202-225-5663
Texas
Gov. Rick Perry (R) 512-463-2000
State Legislature Links
Sen. John Cornyn (R) Fax: 202-228-2856
Sen. Kay Bailey Hutchison (R) Fax: 202-224-0776
Rep. Louis Gohmert (R-1) Fax: 202-225-5866
Rep. Ted Poe (R-2) Fax: 202-225-5547
Rep. Sam Johnson (R-3) Fax: 202-225-1485
Rep. Ralph Hall (R-4) Fax: 202-225-3332
Rep. Jeb Hensarling (R-5) Fax: 202-226-4888
Rep. Joe Barton (R-6) Fax: 202-225-3052
Rep. John Culberson (R-7) Fax: 202-225-4381
Rep. Kevin Brady (R-8) Fax: 202-225-5524
Rep. Al Green (D-9) Fax: 202-225-2947
Rep. Michael McCaul (R-10) Fax: 202-225-5955
Rep. Mike Conaway (R-11) Fax: 202-225-1783
Rep. Kay Granger (R-12) Fax: 202-225-5683
Rep. "Mac" Thornberry (R-13) Fax: 202-225-3486
Rep. Ron Paul (R-14) Fax: 202-226-6553
Rep. Ruben Hinojosa (D-15) Fax: 202-225-5688
Rep. Silvestre Reyes (D-16) Fax: 202-225-2016
Rep. Chet Edwards (D-17) Fax: 202-225-2234
Rep. Sheila Jackson-Lee (D-18) Fax: 202-225-3317
Rep. Randy Neugebauer (R-19) Fax: 202-225-9615
Rep. Charles Gonzalez (D-20) Fax: 202-225-1915
Rep. Lamar Smith (R-21) Fax: 202-225-8628
Rep. Pete Olson (R-22) Fax: 202-225-5241
Rep. Ciro Rodriguez (D-23) Fax: 202-225-2237
Rep. Kenny Marchant (R-24) Fax: 202-225-0074
Rep. Lloyd Doggett (D-25) Fax: 202-225-2947
Rep. Michael Burgess (R-26) Fax: 202-225-2919
Rep. Solomon Ortiz (D-27) Fax: 202-226-1134
Rep. Enrique Cuellar (D-28) Fax: 202-225-1641
Rep. Gene Green (D-29) Fax: 202-225-9903
Rep. Eddie Bernice Johnson (D-30) Fax: 202-226-1477
Rep. John Carter (R-31) Fax: 202-225-5886
Rep. Pete Sessions (R-32) Fax: 202-225-5878
Utah
Gov. Jon Huntsman, Jr. (R) 801-538-1000
State Legislature Links
Sen. Robert F. Bennett (R) Fax: 202-228-1168
Sen. Orrin G. Hatch (R) Fax: 202-224-6331
Rep. Rob Bishop (R-1) Fax: 202-225-5857
Rep. Jim Matheson (D-2) Fax: 202-225-5638
Rep. Chris Cannon (R-3) Fax: 202-225-5629
Vermont
Gov. Jim Douglas (R) 802-828-3333
State Legislature Links
Sen. Bernie Sanders (I) Fax: 202-228-0776
Sen. Patrick J. Leahy (D) Fax: 202-224-3479
Rep. Peter Welch (D-At Large) Fax: 202-225-6790
Virginia
Gov. Tim Kaine (D) 804-786-2211
State Legislature Links
Sen. Jim Webb (D) Fax: 202-228-6363
Sen. Mark Warner (D) Fax: 202-224-6295
Rep. Robert Wittman (R-1) Fax: 202-225-4382
Rep. Glen Nye (D-2) Fax: 202-225-4218
Rep. Robert Scott (D-3) Fax: 202-225-8354
Rep. Randy Forbes (R-4) Fax: 202-226-1170
Rep. Thomas Perriello (D-5) Fax: 202-225-5681
Rep. Bob Goodlatte (R-6) Fax: 202-225-9681
Rep. Eric Cantor (R-7) Fax: 202-225-0011
Rep. Jim Moran (D-8) Fax: 202-225-0017
Rep. Rick Boucher (D-9) Fax: 202-225-0442
Rep. Frank Wolf (R-10) Fax: 202-225-0437
Rep. Gerald Connolly (D-11) Fax: 202-225-3071
Washington
Gov. Christine Gregoire (D) 360-902-4111
State Legislature Links
Sen. Maria Cantwell (D) Fax: 202-228-0514
Sen. Patty Murray (D) Fax: 202-224-0238
Rep. Jay Inslee (D-1) Fax: 202-226-1606
Rep. Rick Larsen (D-2) Fax: 202-225-4420
Rep. Brian Baird (D-3) Fax: 202-225-3478
Rep. Doc Hastings (R-4) Fax: 202-225-3251
Rep. Cathy McMorris (R-5) Fax: 202-225-3392
Rep. Norman Dicks (D-6) Fax: 202-226-1176
Rep. Jim McDermott (D-7) Fax: 202-225-6197
Rep. Dave Reichert (R-8) Fax: 202-225-4282
Rep. Adam Smith (D-9) Fax: 202-225-5893
West Virginia
Gov. Joe Manchin III (D) 888-438-2731
State Legislature Links
Sen. Robert C. Byrd (D) Fax: 202-228-0002
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Rep. Alan Mollohan (D-1) Fax: 202-225-7564
Rep. Shelley Capito (R-2) Fax: 202-225-7856
Rep. Nick Rahall (D-3) Fax: 202-225-9061
Wisconsin
Gov. Jim Doyle (D) 608-266-1212
State Legislature Links
Sen. Russell D. Feingold (D) Fax: 202-224-2725
Sen. Herb Kohl (D) Fax: 202-224-9787
Rep. Paul Ryan (R-1) Fax: 202-225-3393
Rep. Tammy Baldwin (D-2) Fax: 202-225-6942
Rep. Ron Kind (D-3) Fax: 202-225-5739
Rep. Gwen Moore (D-4) Fax: 202-225-8135
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Rep. Tom Petri (R-6) Fax: 202-225-2356
Rep. David Obey (D-7) Fax: 715-842-4488
Rep. Steve Kagan (D-8) Fax: 202-225-5729
Wyoming
Gov. Dave Freudenthal (D) 307-777-7434
State Legislature Links
Sen. Mike Enzi (R) Fax: 202-228-0359
Sen. John Barrasso (R) Fax: 202-224-1724
Rep. Barbara Cubin (R-At Large) Fax: 202-225-3057
Territories and Delegates:
American Samoa
Gov. Togiola Tulafono (D) 684-633-4116
Delegate Eni Faleomavaega (D-At Large) Fax: 202-225-8757
Washington, D.C.
DC City Council Links
Delegate Eleanor Holmes Norton (D-At Large) Fax 202-225-3002
Guam
Gov. Felix Camacho (R)
Territorial Legislature Links
Delegate Madeilene Bordallo (D-At Large) Fax: 202-226-0341
Northern Mariana Islands
Gov. Benigno Fital (Covenant) 670-664-1100
Territorial Legislature Links
Puerto Rico
Gov. Luis Fortuno (R) 787-721-7000
Territorial Legislature Links
Delegate Pedro Pierluisi (D-At Large) Fax: 202-225-2154
Virgin Islands
Gov. John de Jongh (D)
Territorial Legislature Links
Delegate Donna Christensen (D-At Large) Fax: 202-225-5517
H. R. 1230 Current Sponsors
The current cosponsors of the bill are listed here: http://thomas.loc.gov/cgi-bin/bdquery/z?d111:HR01230:@@@P. They are:
COSPONSORS(38), ALPHABETICAL [followed by Cosponsors withdrawn]: (Sort: by date)
Rep Abercrombie, Neil [HI-1] - 2/26/2009 Rep Altmire, Jason [PA-4] - 6/23/2009
Rep Arcuri, Michael A. [NY-24] - 2/26/2009 Rep Baldwin, Tammy [WI-2] - 6/23/2009
Rep Barrow, John [GA-12] - 6/23/2009 Rep Bishop, Sanford D., Jr. [GA-2] - 2/26/2009
Rep Bishop, Timothy H. [NY-1] - 5/21/2009 Rep Bordallo, Madeleine Z. [GU] - 2/26/2009
Rep Braley, Bruce L. [IA-1] - 9/29/2009 Rep Burgess, Michael C. [TX-26] - 5/21/2009
Rep Butterfield, G. K. [NC-1] - 10/6/2009 Rep Conyers, John, Jr. [MI-14] - 2/26/2009
Rep DeGette, Diana [CO-1] - 2/26/2009 Rep Emerson, Jo Ann [MO-8] - 2/26/2009
Rep Engel, Eliot L. [NY-17] - 9/8/2009 Rep Eshoo, Anna G. [CA-14] - 2/26/2009
Rep Frank, Barney [MA-4] - 2/26/2009 Rep Gonzalez, Charles A. [TX-20] - 5/21/2009
Rep Green, Gene [TX-29] - 2/26/2009 Rep Hinchey, Maurice D. [NY-22] - 9/8/2009
Rep Hirono, Mazie K. [HI-2] - 2/26/2009 Rep Honda, Michael M. [CA-15] - 4/2/2009
Rep King, Peter T. [NY-3] - 2/26/2009 Rep Lewis, John [GA-5] - 2/26/2009
Rep McCotter, Thaddeus G. [MI-11] - 9/30/2009 Rep McDermott, Jim [WA-7] - 2/26/2009
Rep McGovern, James P. [MA-3] - 2/26/2009 Rep Miller, Candice S. [MI-10] - 9/8/2009
Rep Murphy, Christopher S. [CT-5] - 6/23/2009 Rep Murtha, John P. [PA-12] - 2/26/2009
Rep Platts, Todd Russell [PA-19] - 5/4/2009 Rep Schakowsky, Janice D. [IL-9] - 9/29/2009
Rep Schwartz, Allyson Y. [PA-13] - 2/26/2009 Rep Sestak, Joe [PA-7] - 6/4/2009
Rep Snyder, Vic [AR-2] - 10/7/2009 Rep Stark, Fortney Pete [CA-13] - 9/8/2009
Rep Van Hollen, Chris [MD-8] - 2/26/2009 Rep Wolf, Frank R. [VA-10] - 2/26/2009
COSPONSORS(38), ALPHABETICAL [followed by Cosponsors withdrawn]: (Sort: by date)
Rep Abercrombie, Neil [HI-1] - 2/26/2009 Rep Altmire, Jason [PA-4] - 6/23/2009
Rep Arcuri, Michael A. [NY-24] - 2/26/2009 Rep Baldwin, Tammy [WI-2] - 6/23/2009
Rep Barrow, John [GA-12] - 6/23/2009 Rep Bishop, Sanford D., Jr. [GA-2] - 2/26/2009
Rep Bishop, Timothy H. [NY-1] - 5/21/2009 Rep Bordallo, Madeleine Z. [GU] - 2/26/2009
Rep Braley, Bruce L. [IA-1] - 9/29/2009 Rep Burgess, Michael C. [TX-26] - 5/21/2009
Rep Butterfield, G. K. [NC-1] - 10/6/2009 Rep Conyers, John, Jr. [MI-14] - 2/26/2009
Rep DeGette, Diana [CO-1] - 2/26/2009 Rep Emerson, Jo Ann [MO-8] - 2/26/2009
Rep Engel, Eliot L. [NY-17] - 9/8/2009 Rep Eshoo, Anna G. [CA-14] - 2/26/2009
Rep Frank, Barney [MA-4] - 2/26/2009 Rep Gonzalez, Charles A. [TX-20] - 5/21/2009
Rep Green, Gene [TX-29] - 2/26/2009 Rep Hinchey, Maurice D. [NY-22] - 9/8/2009
Rep Hirono, Mazie K. [HI-2] - 2/26/2009 Rep Honda, Michael M. [CA-15] - 4/2/2009
Rep King, Peter T. [NY-3] - 2/26/2009 Rep Lewis, John [GA-5] - 2/26/2009
Rep McCotter, Thaddeus G. [MI-11] - 9/30/2009 Rep McDermott, Jim [WA-7] - 2/26/2009
Rep McGovern, James P. [MA-3] - 2/26/2009 Rep Miller, Candice S. [MI-10] - 9/8/2009
Rep Murphy, Christopher S. [CT-5] - 6/23/2009 Rep Murtha, John P. [PA-12] - 2/26/2009
Rep Platts, Todd Russell [PA-19] - 5/4/2009 Rep Schakowsky, Janice D. [IL-9] - 9/29/2009
Rep Schwartz, Allyson Y. [PA-13] - 2/26/2009 Rep Sestak, Joe [PA-7] - 6/4/2009
Rep Snyder, Vic [AR-2] - 10/7/2009 Rep Stark, Fortney Pete [CA-13] - 9/8/2009
Rep Van Hollen, Chris [MD-8] - 2/26/2009 Rep Wolf, Frank R. [VA-10] - 2/26/2009
H. R. 1230 - Support Bill HR 1230
Please contact your Representatives and ask for their support of H. R. 1230, a bill to amend the Public Health Services Act to establish a National Acquired Bone Marrow Failure Disease Registry.
111th CONGRESS
1st Session
H. R. 1230
To amend the Public Health Service Act to provide for the establishment of a National Acquired Bone Marrow Failure Disease Registry, to authorize research on acquired bone marrow failure diseases, and for other purposes.
--------------------------------------------------------------------------------
IN THE HOUSE OF REPRESENTATIVES
February 26, 2009
Ms. Matsui (for herself, Mr. Bishop of Georgia, Mr. Murtha, Mr. McDermott, Mrs. Emerson, Mr. Gene Green of Texas, Mr. Abercrombie, Ms. Schwartz, Mr. Conyers, Ms. Hirono, Ms. Bordallo, Mr. Lewis of Georgia, Mr. Frank of Massachusetts, Mr. Wolf, Mr. King of New York, Mr. Van Hollen, Mr. McGovern, Ms. DeGette, Mr. Arcuri, and Ms. Eshoo) introduced the following bill; which was referred to the Committee on Energy and Commerce
A BILL
To amend the Public Health Service Act to provide for the establishment of a National Acquired Bone Marrow Failure Disease Registry, to authorize research on acquired bone marrow failure diseases, and for other purposes.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. Short title.
This Act may be cited as the “Bone Marrow Failure Disease Research and Treatment Act of 2009”.
SEC. 2. Findings.
The Congress finds the following:
(1) Between 20,000 and 30,000 Americans are diagnosed each year with myelodysplastic syndromes, aplastic anemia, paroxysmal nocturnal hemoglobinuria, and other acquired bone marrow failure diseases.
(2) Acquired bone marrow failure diseases have a debilitating and often fatal impact on those diagnosed with these disease.
(3) While some treatments for acquired bone marrow failure diseases can prolong and improve the quality of patients’ lives, there is no single cure for these diseases.
(4) The prevalence of acquired bone marrow failure diseases in the United States will continue to grow as the general public ages.
(5) Evidence exists suggesting that acquired bone marrow failure diseases occur more often in minority populations, particularly in Asian-American and Hispanic/Latino populations.
(6) The National Heart, Lung, and Blood Institute and the National Cancer Institute have conducted important research into the causes of and treatments for acquired bone marrow failure diseases.
(7) The National Marrow Donor Program Registry has made significant contributions to the fight against bone marrow failure diseases by connecting millions of potential marrow donors with individuals and families suffering from these conditions.
(8) Despite these advances, a more comprehensive Federal strategic effort among numerous Federal agencies is needed to discover a cure for acquired bone marrow failure disorders.
(9) Greater Federal surveillance of acquired bone marrow failure diseases is needed to gain a better understanding of the causes of acquired bone marrow failure diseases.
(10) The Federal Government should increase its research support for and engage with public and private organizations in developing a comprehensive approach to combat and cure acquired bone marrow failure diseases.
SEC. 3. National Acquired Bone Marrow Failure Disease Registry.
Part B of the Public Health Service Act (42 U.S.C. 311 et seq.) is amended by inserting after section 317T the following:
“SEC. 317U. National Acquired Bone Marrow Failure Disease Registry.
“(a) Establishment of registry.—
“(1) IN GENERAL.—Not later than 6 months after the date of the enactment of this section, the Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall—
“(A) develop a system to collect data on acquired bone marrow failure diseases; and
“(B) establish and maintain a national and publicly available registry, to be known as the National Acquired Bone Marrow Failure Disease Registry, in accordance with paragraph (3).
“(2) RECOMMENDATIONS OF ADVISORY COMMITTEE.—In carrying out this subsection, the Secretary shall take into consideration the recommendations of the Advisory Committee on Acquired Bone Marrow Failure Diseases established under subsection (b).
“(3) PURPOSES OF REGISTRY.—The National Acquired Bone Marrow Failure Disease Registry—
“(A) shall identify the incidence and prevalence of acquired bone marrow failure diseases in the United States;
“(B) shall be used to collect and store data on acquired bone marrow failure diseases, including data concerning—
“(i) the age, race or ethnicity, general geographic location, sex, and family history of individuals who are diagnosed with acquired bone marrow failure diseases, and any other characteristics of such individuals determined appropriate by the Secretary;
“(ii) the genetic and environmental factors that may be associated with developing acquired bone marrow failure diseases;
“(iii) treatment approaches for dealing with acquired bone marrow failure diseases;
“(iv) outcomes for individuals treated for acquired bone marrow failure diseases, including outcomes for recipients of stem cell therapeutic products as contained in the database established pursuant to section 379A; and
“(v) any other factors pertaining to acquired bone marrow failure diseases determined appropriate by the Secretary; and
“(C) shall be made available—
“(i) to the general public; and
“(ii) to researchers to facilitate further research into the causes of, and treatments for, acquired bone marrow failure diseases in accordance with standard practices of the Centers for Disease Control and Preventions.
“(b) Advisory committee.—
“(1) ESTABLISHMENT.—Not later than 6 months after the date of the enactment of this section, the Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall establish an advisory committee, to be known as the Advisory Committee on Acquired Bone Marrow Failure Diseases.
“(2) MEMBERS.—The members of the Advisory Committee on Acquired Bone Marrow Failure Diseases shall be appointed by the Secretary, acting through the Director of the Centers for Disease Control and Prevention, and shall include at least one representative from each of the following:
“(A) A national patient advocacy organization with experience advocating on behalf of patients suffering from acquired bone marrow failure diseases.
“(B) The National Institutes of Health, including at least one representative from each of—
“(i) the National Cancer Institute;
“(ii) the National Heart, Lung, and Blood Institute; and
“(iii) the Office of Rare Diseases.
“(C) The Centers for Disease Control and Prevention.
“(D) Clinicians with experience in—
“(i) diagnosing or treating acquired bone marrow failure diseases; and
“(ii) medical data registries.
“(E) Epidemiologists who have experience with data registries.
“(F) Publicly or privately funded researchers who have experience researching acquired bone marrow failure diseases.
“(G) The entity operating the C.W. Bill Young Cell Transplantation Program established pursuant to section 379 and the entity operating the C.W. Bill Young Cell Transplantation Program Outcomes Database.
“(3) RESPONSIBILITIES.—The Advisory Committee on Acquired Bone Marrow Failure Diseases shall provide recommendations to the Secretary on the establishment and maintenance of the National Acquired Bone Marrow Failure Disease Registry, including recommendations on the collection, maintenance, and dissemination of data.
“(4) PUBLIC AVAILABILITY.—The Secretary shall make the recommendations of the Advisory Committee on Acquired Bone Marrow Failure Disease publicly available.
“(c) Grants.—The Secretary, acting through the Director of the Centers for Disease Control and Prevention, may award grants to, and enter into contracts and cooperative agreements with, public or private nonprofit entities for the management of, as well as the collection, analysis, and reporting of data to be included in, the National Acquired Bone Marrow Failure Disease Registry.
“(d) Definition.—In this section, the term ‘acquired bone marrow failure disease’ means—
“(1) myelodysplastic syndromes (MDS);
“(2) aplastic anemia;
“(3) paroxysmal nocturnal hemoglobinuria (PNH);
“(4) pure red cell aplasia;
“(5) acute myeloid leukemia that has progressed from myelodysplastic syndromes; or
“(6) large granular lymphocytic leukemia.
“(e) Authorization of appropriations.—There is authorized to be appropriated to carry out this section $3,000,000 for each of fiscal years 2010 through 2014.”.
SEC. 4. Pilot studies through the agency for toxic substances and disease registry.
(a) Pilot studies.—The Secretary of Health and Human Services, acting through the Administrator of the Agency for Toxic Substances and Disease Registry, shall conduct pilot studies to determine which environmental factors, including exposure to toxins, may cause acquired bone marrow failure diseases.
(b) Collaboration with the Radiation Injury Treatment Network.—In carrying out the directives of this section, the Secretary may collaborate with the Radiation Injury Treatment Network of the C.W. Bill Young Cell Transplantation Program established pursuant to section 379 of the Public Health Service Act (42 U.S.C. 274j) to—
(1) augment data for the pilot studies authorized by this section;
(2) access technical assistance that may be provided by the Radiation Injury Treatment Network; or
(3) perform joint research projects.
(c) Authorization of appropriations.—There is authorized to be appropriated to carry out this section $1,000,000 for each of fiscal years 2010 through 2014.
SEC. 5. Minority-focused programs on acquired bone marrow failure diseases.
Title XVII of the Public Health Service Act (42 U.S.C. 300u et seq.) is amended by inserting after section 1707 the following:
“Minority-focused programs on acquired bone marrow failure diseases
“Sec. 1707A. (a) Information and referral services.—
“(1) IN GENERAL.—Not later than 6 months after the date of the enactment of this section, the Secretary, acting through the Deputy Assistant Secretary for Minority Health, shall establish and coordinate outreach and informational programs targeted to minority populations affected by acquired bone marrow failure diseases.
“(2) PROGRAM REQUIREMENTS.—Minority-focused outreach and informational programs authorized by this section—
“(A) shall make information about treatment options and clinical trials for acquired bone marrow failure diseases publicly available, and
“(B) shall provide referral services for treatment options and clinical trials, at the national minority health resource center supported under section 1707(b)(8) (including by means of the center’s website, through appropriate locations such as the center’s knowledge center, and through appropriate programs such as the center’s resource persons network) and through minority health consultants located at each Department of Health and Human Services regional office.
“(b) Hispanic and asian-american and pacific islander outreach.—
“(1) IN GENERAL.—The Secretary, acting through the Deputy Assistant Secretary for Minority Health, shall undertake a coordinated outreach effort to connect Hispanic, Asian-American, and Pacific Islander communities with comprehensive services focused on treatment of, and information about, acquired bone marrow failure diseases.
“(2) COLLABORATION.—In carrying out this subsection, the Secretary may collaborate with public health agencies, nonprofit organizations, community groups, and online entities to disseminate information about treatment options and clinical trials for acquired bone marrow failure diseases.
“(c) Grants and cooperative agreements.—
“(1) IN GENERAL.—Not later than 6 months after the date of the enactment of this section, the Secretary, acting through the Deputy Assistant Secretary for Minority Health, shall award grants to, or enter into cooperative agreements with, entities to perform research on acquired bone marrow failure diseases.
“(2) REQUIREMENT.—Grants and cooperative agreements authorized by this subsection shall be awarded or entered into on a competitive, peer-reviewed basis.
“(3) SCOPE OF RESEARCH.—Research funded under this section shall examine factors affecting the incidence of acquired bone marrow failure diseases in minority populations.
“(d) Definition.—In this section, the term ‘acquired bone marrow failure disease’ has the meaning given to such term in section 317U(d).
“(e) Authorization of appropriations.—There is authorized to be appropriated to carry out this section $2,000,000 for each of fiscal years 2010 through 2014.”.
SEC. 6. Diagnosis and quality of care for acquired bone marrow failure diseases.
(a) Grants.—The Secretary of Health and Human Services, acting through the Director of the Agency for Healthcare Research and Quality, shall award grants to entities to improve diagnostic practices and quality of care with respect to patients with acquired bone marrow failure diseases.
(b) Authorization of appropriations.—There is authorized to be appropriated to carry out this section $2,000,000 for each of fiscal years 2010 through 2014.
SEC. 7. Definition.
In this Act, the term “acquired bone marrow failure disease” means—
(1) myelodysplastic syndromes (MDS);
(2) aplastic anemia;
(3) paroxysmal nocturnal hemoglobinuria (PNH);
(4) pure red cell aplasia;
(5) acute myeloid leukemia that progressed from myelodysplastic syndromes; or
(6) large granular lymphocytic leukemia
111th CONGRESS
1st Session
H. R. 1230
To amend the Public Health Service Act to provide for the establishment of a National Acquired Bone Marrow Failure Disease Registry, to authorize research on acquired bone marrow failure diseases, and for other purposes.
--------------------------------------------------------------------------------
IN THE HOUSE OF REPRESENTATIVES
February 26, 2009
Ms. Matsui (for herself, Mr. Bishop of Georgia, Mr. Murtha, Mr. McDermott, Mrs. Emerson, Mr. Gene Green of Texas, Mr. Abercrombie, Ms. Schwartz, Mr. Conyers, Ms. Hirono, Ms. Bordallo, Mr. Lewis of Georgia, Mr. Frank of Massachusetts, Mr. Wolf, Mr. King of New York, Mr. Van Hollen, Mr. McGovern, Ms. DeGette, Mr. Arcuri, and Ms. Eshoo) introduced the following bill; which was referred to the Committee on Energy and Commerce
A BILL
To amend the Public Health Service Act to provide for the establishment of a National Acquired Bone Marrow Failure Disease Registry, to authorize research on acquired bone marrow failure diseases, and for other purposes.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. Short title.
This Act may be cited as the “Bone Marrow Failure Disease Research and Treatment Act of 2009”.
SEC. 2. Findings.
The Congress finds the following:
(1) Between 20,000 and 30,000 Americans are diagnosed each year with myelodysplastic syndromes, aplastic anemia, paroxysmal nocturnal hemoglobinuria, and other acquired bone marrow failure diseases.
(2) Acquired bone marrow failure diseases have a debilitating and often fatal impact on those diagnosed with these disease.
(3) While some treatments for acquired bone marrow failure diseases can prolong and improve the quality of patients’ lives, there is no single cure for these diseases.
(4) The prevalence of acquired bone marrow failure diseases in the United States will continue to grow as the general public ages.
(5) Evidence exists suggesting that acquired bone marrow failure diseases occur more often in minority populations, particularly in Asian-American and Hispanic/Latino populations.
(6) The National Heart, Lung, and Blood Institute and the National Cancer Institute have conducted important research into the causes of and treatments for acquired bone marrow failure diseases.
(7) The National Marrow Donor Program Registry has made significant contributions to the fight against bone marrow failure diseases by connecting millions of potential marrow donors with individuals and families suffering from these conditions.
(8) Despite these advances, a more comprehensive Federal strategic effort among numerous Federal agencies is needed to discover a cure for acquired bone marrow failure disorders.
(9) Greater Federal surveillance of acquired bone marrow failure diseases is needed to gain a better understanding of the causes of acquired bone marrow failure diseases.
(10) The Federal Government should increase its research support for and engage with public and private organizations in developing a comprehensive approach to combat and cure acquired bone marrow failure diseases.
SEC. 3. National Acquired Bone Marrow Failure Disease Registry.
Part B of the Public Health Service Act (42 U.S.C. 311 et seq.) is amended by inserting after section 317T the following:
“SEC. 317U. National Acquired Bone Marrow Failure Disease Registry.
“(a) Establishment of registry.—
“(1) IN GENERAL.—Not later than 6 months after the date of the enactment of this section, the Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall—
“(A) develop a system to collect data on acquired bone marrow failure diseases; and
“(B) establish and maintain a national and publicly available registry, to be known as the National Acquired Bone Marrow Failure Disease Registry, in accordance with paragraph (3).
“(2) RECOMMENDATIONS OF ADVISORY COMMITTEE.—In carrying out this subsection, the Secretary shall take into consideration the recommendations of the Advisory Committee on Acquired Bone Marrow Failure Diseases established under subsection (b).
“(3) PURPOSES OF REGISTRY.—The National Acquired Bone Marrow Failure Disease Registry—
“(A) shall identify the incidence and prevalence of acquired bone marrow failure diseases in the United States;
“(B) shall be used to collect and store data on acquired bone marrow failure diseases, including data concerning—
“(i) the age, race or ethnicity, general geographic location, sex, and family history of individuals who are diagnosed with acquired bone marrow failure diseases, and any other characteristics of such individuals determined appropriate by the Secretary;
“(ii) the genetic and environmental factors that may be associated with developing acquired bone marrow failure diseases;
“(iii) treatment approaches for dealing with acquired bone marrow failure diseases;
“(iv) outcomes for individuals treated for acquired bone marrow failure diseases, including outcomes for recipients of stem cell therapeutic products as contained in the database established pursuant to section 379A; and
“(v) any other factors pertaining to acquired bone marrow failure diseases determined appropriate by the Secretary; and
“(C) shall be made available—
“(i) to the general public; and
“(ii) to researchers to facilitate further research into the causes of, and treatments for, acquired bone marrow failure diseases in accordance with standard practices of the Centers for Disease Control and Preventions.
“(b) Advisory committee.—
“(1) ESTABLISHMENT.—Not later than 6 months after the date of the enactment of this section, the Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall establish an advisory committee, to be known as the Advisory Committee on Acquired Bone Marrow Failure Diseases.
“(2) MEMBERS.—The members of the Advisory Committee on Acquired Bone Marrow Failure Diseases shall be appointed by the Secretary, acting through the Director of the Centers for Disease Control and Prevention, and shall include at least one representative from each of the following:
“(A) A national patient advocacy organization with experience advocating on behalf of patients suffering from acquired bone marrow failure diseases.
“(B) The National Institutes of Health, including at least one representative from each of—
“(i) the National Cancer Institute;
“(ii) the National Heart, Lung, and Blood Institute; and
“(iii) the Office of Rare Diseases.
“(C) The Centers for Disease Control and Prevention.
“(D) Clinicians with experience in—
“(i) diagnosing or treating acquired bone marrow failure diseases; and
“(ii) medical data registries.
“(E) Epidemiologists who have experience with data registries.
“(F) Publicly or privately funded researchers who have experience researching acquired bone marrow failure diseases.
“(G) The entity operating the C.W. Bill Young Cell Transplantation Program established pursuant to section 379 and the entity operating the C.W. Bill Young Cell Transplantation Program Outcomes Database.
“(3) RESPONSIBILITIES.—The Advisory Committee on Acquired Bone Marrow Failure Diseases shall provide recommendations to the Secretary on the establishment and maintenance of the National Acquired Bone Marrow Failure Disease Registry, including recommendations on the collection, maintenance, and dissemination of data.
“(4) PUBLIC AVAILABILITY.—The Secretary shall make the recommendations of the Advisory Committee on Acquired Bone Marrow Failure Disease publicly available.
“(c) Grants.—The Secretary, acting through the Director of the Centers for Disease Control and Prevention, may award grants to, and enter into contracts and cooperative agreements with, public or private nonprofit entities for the management of, as well as the collection, analysis, and reporting of data to be included in, the National Acquired Bone Marrow Failure Disease Registry.
“(d) Definition.—In this section, the term ‘acquired bone marrow failure disease’ means—
“(1) myelodysplastic syndromes (MDS);
“(2) aplastic anemia;
“(3) paroxysmal nocturnal hemoglobinuria (PNH);
“(4) pure red cell aplasia;
“(5) acute myeloid leukemia that has progressed from myelodysplastic syndromes; or
“(6) large granular lymphocytic leukemia.
“(e) Authorization of appropriations.—There is authorized to be appropriated to carry out this section $3,000,000 for each of fiscal years 2010 through 2014.”.
SEC. 4. Pilot studies through the agency for toxic substances and disease registry.
(a) Pilot studies.—The Secretary of Health and Human Services, acting through the Administrator of the Agency for Toxic Substances and Disease Registry, shall conduct pilot studies to determine which environmental factors, including exposure to toxins, may cause acquired bone marrow failure diseases.
(b) Collaboration with the Radiation Injury Treatment Network.—In carrying out the directives of this section, the Secretary may collaborate with the Radiation Injury Treatment Network of the C.W. Bill Young Cell Transplantation Program established pursuant to section 379 of the Public Health Service Act (42 U.S.C. 274j) to—
(1) augment data for the pilot studies authorized by this section;
(2) access technical assistance that may be provided by the Radiation Injury Treatment Network; or
(3) perform joint research projects.
(c) Authorization of appropriations.—There is authorized to be appropriated to carry out this section $1,000,000 for each of fiscal years 2010 through 2014.
SEC. 5. Minority-focused programs on acquired bone marrow failure diseases.
Title XVII of the Public Health Service Act (42 U.S.C. 300u et seq.) is amended by inserting after section 1707 the following:
“Minority-focused programs on acquired bone marrow failure diseases
“Sec. 1707A. (a) Information and referral services.—
“(1) IN GENERAL.—Not later than 6 months after the date of the enactment of this section, the Secretary, acting through the Deputy Assistant Secretary for Minority Health, shall establish and coordinate outreach and informational programs targeted to minority populations affected by acquired bone marrow failure diseases.
“(2) PROGRAM REQUIREMENTS.—Minority-focused outreach and informational programs authorized by this section—
“(A) shall make information about treatment options and clinical trials for acquired bone marrow failure diseases publicly available, and
“(B) shall provide referral services for treatment options and clinical trials, at the national minority health resource center supported under section 1707(b)(8) (including by means of the center’s website, through appropriate locations such as the center’s knowledge center, and through appropriate programs such as the center’s resource persons network) and through minority health consultants located at each Department of Health and Human Services regional office.
“(b) Hispanic and asian-american and pacific islander outreach.—
“(1) IN GENERAL.—The Secretary, acting through the Deputy Assistant Secretary for Minority Health, shall undertake a coordinated outreach effort to connect Hispanic, Asian-American, and Pacific Islander communities with comprehensive services focused on treatment of, and information about, acquired bone marrow failure diseases.
“(2) COLLABORATION.—In carrying out this subsection, the Secretary may collaborate with public health agencies, nonprofit organizations, community groups, and online entities to disseminate information about treatment options and clinical trials for acquired bone marrow failure diseases.
“(c) Grants and cooperative agreements.—
“(1) IN GENERAL.—Not later than 6 months after the date of the enactment of this section, the Secretary, acting through the Deputy Assistant Secretary for Minority Health, shall award grants to, or enter into cooperative agreements with, entities to perform research on acquired bone marrow failure diseases.
“(2) REQUIREMENT.—Grants and cooperative agreements authorized by this subsection shall be awarded or entered into on a competitive, peer-reviewed basis.
“(3) SCOPE OF RESEARCH.—Research funded under this section shall examine factors affecting the incidence of acquired bone marrow failure diseases in minority populations.
“(d) Definition.—In this section, the term ‘acquired bone marrow failure disease’ has the meaning given to such term in section 317U(d).
“(e) Authorization of appropriations.—There is authorized to be appropriated to carry out this section $2,000,000 for each of fiscal years 2010 through 2014.”.
SEC. 6. Diagnosis and quality of care for acquired bone marrow failure diseases.
(a) Grants.—The Secretary of Health and Human Services, acting through the Director of the Agency for Healthcare Research and Quality, shall award grants to entities to improve diagnostic practices and quality of care with respect to patients with acquired bone marrow failure diseases.
(b) Authorization of appropriations.—There is authorized to be appropriated to carry out this section $2,000,000 for each of fiscal years 2010 through 2014.
SEC. 7. Definition.
In this Act, the term “acquired bone marrow failure disease” means—
(1) myelodysplastic syndromes (MDS);
(2) aplastic anemia;
(3) paroxysmal nocturnal hemoglobinuria (PNH);
(4) pure red cell aplasia;
(5) acute myeloid leukemia that progressed from myelodysplastic syndromes; or
(6) large granular lymphocytic leukemia
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