
Former state Rep. Maggie O’Neil, of Saco, sits at her bed in Maine Medical Center in Portland on Friday. O’Neil, who has acute myeloid leukemia, is seeking a bone marrow donor. Shawn Patrick Ouellette/Portland Press Herald
When she first stepped into urgent care in early December, Maggie O’Neil wondered whether her unaccounted-for bruises and fatigue were worth the wait for a clinician.
“I thought I had low iron or something,” O’Neil said in a phone call last week. But when the numbers came back “funny,” the former Democratic state representative for Saco was referred to Maine Medical Center.
“It just kind of was a whirlwind after that,” she said.
O’Neil, 35, was transferred to Maine Medical Center, where further tests showed that she has acute myeloid leukemia, a cancer of the blood and bone marrow. Often referred to as AML, it is the most common type of acute leukemia in adults, according to the National Cancer Institute.
She is awaiting test results to determine whether her brother, Max, 33, could provide the transplant. If he is a match, the transplant could happen as soon as mid-March, O’Neil said.
If not, O’Neil will need to turn to an anonymous donor through the nonprofit NMDP. Formerly known as the National Marrow Donor Program and Be The Match, the group matches volunteer donors and patients in need to facilitate bone marrow donations across states and countries.
“I haven’t googled anything about the disease, just because I didn’t want to see any kind of horror stories,” she said. “I’ve really just been taking it one day at a time and listening to what my doctors say, and not spending time spinning about other stuff.”
O’Neil stayed at the hospital for more than a month to undergo chemotherapy, which helped slow the cancer’s spread through her bloodstream but could not remove it from her marrow. So doctors recommended a bone marrow transplant.
“I’ll just do rounds of chemo until I’m able to get a transplant,” O’Neil said. “I’ll be taking the immune system of whoever donates. That’ll give me the building blocks.”

O’Neil at Maine Medical Center in Portland. Shawn Patrick Ouellette/Portland Press Herald
For O’Neil’s father, Christopher O’Neil, his daughter’s need was a window into the broader landscape of need. He considered signing up for the bone marrow registry but learned that he was too late: Only those 40 or younger can sign up. Those on the registry age out of it at 60, said Erica Sevilla, public relations manager for NMDP.
That restriction helps ensure only the most viable donors are considered, Sevilla said. Doctors request donors under the age of 34 in 75% of cases, she said.
In a post shared widely on Facebook, Christopher O’Neil urged community members to sign up for the marrow donor registry if they are young enough to do so and, if not, to encourage their younger loved ones to sign up.
“The interaction on the Facebook post confirmed that I wasn’t the only one in the dark about that (age cap),” he said on a Thursday phone call.
Those between 18 and 40 can join the national marrow registry by visiting my.bethematch.org/PRMaine4Maggie.
Hundreds of users shared and commented on the post, voicing their support for O’Neil and signaling that they had signed up for the registry. He said support seemed especially poignant among residents of Saco, which she represented in the state House of Representatives during her final term.
“I’ve had friends, colleagues and acquaintances dating back decades who came out of the woodwork to respond positively to that one rambling post,” Christopher O’Neil said. “I’ve said for decades that Maine is a big small town. … (This) proves me right.”
AML is a particularly aggressive form of leukemia, and it is most often referred for bone marrow transplants, said Sevilla.
“It is the No. 1 diagnosis that is treated by transplant,” Sevilla said.
Three times out of 10, a patient can find a suitable match in their family, but most still end up turning to the registry, Sevilla said.
FINDING A MATCH IS DIFFICULT
Matching marrow is a complicated process, and it can take years for a potential donor to be tapped, if they are at all.
In 2023, the latest year for which data is available, more than 31,000 Mainers were registered with NMDP, a fraction of the roughly 9 million potential donors nationwide. From 2019-23, 65 of them went through with donations. During that same time frame, 327 Mainers searched for a viable donor.
The likelihood of finding a viable match from the registry largely depends on the patient’s ethnic background, according to NMDP.
Individuals of Caucasian descent have a roughly 79% chance of being paired with a fully matched donor. But that figure drops to 60% for Native Americans and to less than 50% for Asian and Pacific Islander, Hispanic, Latino and Black people — for which success rate drops to 29%, largely due to lack of donors, according to NMDP.
Human leukocyte antigens — the genetic markers used to determine a match — are inherited, meaning that donors and patients are likely to share the same ethnic background, but present-day geography makes little difference.
“At the end of the day, where a donor lives isn’t as important as where their grandparents or great-grandparents lived,” Sevilla said. “There’s definitely a disparity that exists among ethnically diverse patients.”
Recent developments in pre- and post-transplant treatments have improved outcomes for patients whose donors are not perfect matches, said Stephen Spellman, NMDP’s vice president of research and senior scientific director. That could help improve outcomes for patients in historically difficult-to-match groups.
“Where we’ve seen pretty tremendous growth in recent years is in the mismatched, unrelated donor setting,” Spellman said. “So patients that weren’t finding a match previously on the registry are able to find a suitable match and pursue curative therapy.”
YOUNG DONORS NEEDED
Still, Spellman noted that the registry needs a constant stream of young donors, as those already on it grow older and eventually age out. He said donors between 18 and 30 tend to offer the best outcomes.
“Now, does that mean that a donor over the age of 30 is always a deal-breaker? No,” Spellman said. “There’s just some additional risk that’s taken.”
O’Neil said she was “totally shocked and floored” by the outpouring of support from friends and constituents, as well as more than $40,000 that was donated to a GoFundMe to help cover the costs associated with a monthlong stay at the Dana-Farber Cancer Institute and routine trips to Boston following the transplant.
“Just feeling supported and loved is really helping make it easier,” she said. She said the staff on Maine Med’s oncology floor have been supportive and encouraging.
O’Neil said she’s seen firsthand how important a reliable donor registry is, for any kind of transplant.
“Whatever people are willing and able to do, I’ve just seen the impact from myself and people in here,” O’Neil said from the oncology wing.
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