In 2018, as a senior at the University of Kentucky, Nicole Karem joined the NMDP registry for blood stem cell donors. In January 2022 the registry called: she was the only match for Judy Mangione, an 80-year-old mathematics education professor in Massachusetts with a rare bone marrow cancer. Karem, by then a law student in Washington, DC, donated at Georgetown University Hospital, and Mangione had her transplant at Dana-Farber the next day. After the required waiting period the two wrote letters, then moved on to texts and calls, and they met in Washington in 2023. Karem has since visited Mangione in Massachusetts several times, and Mangione's checkups continue to go well.