City of Hope•Samaritan Bone Marrow Transplantation Program Provides Milestone 300th BMT to Scottsdale Woman

City of Hope
Wednesday, 28 May 2003

Scottsdale resident Lynn Mesnik is scheduled on Friday, May 30, to become the 300th bone marrow transplant (BMT) patient at the City of Hope•Samaritan Bone Marrow Transplantation Program, located at Banner Good Samaritan Medical Center in downtown Phoenix, Ariz. This milestone comes as the Valley's busiest and most comprehensive BMT program begins an expansion project that will double the number of inpatient BMT beds (from seven to 14), and greatly increase the capacity to provide care for outpatients.

Since it opened in 1996, the City of Hope•Samaritan BMT Program has provided lifesaving BMTs, comprehensive work-ups on 900 potential BMT patients, and has obtained marrow or peripheral blood stem cells from donors to be transplanted into seriously ill recipients. The unit's doctors and nurses also provide follow-up treatment for its BMT patients, as well as for BMT patients who received their procedures at programs outside of Phoenix. This resulted in 3,024 outpatient visits in 2002.

The program is a partnership between Los Angeles-based City of Hope Cancer Center and Banner Health. City of Hope is among the elite providers of BMT in the world, and Banner Good Samaritan provides more cancer care than any hospital in Arizona.

"The quality of our partnership with the City of Hope is rare in health care," said Banner Good Samaritan CEO Steven L. Seiler. "The success of this partnership is driven by our mutual recognition that excellent patient care comes first. This partnership has created a high quality program that allows patients in the Phoenix area to stay close to home during their treatment."

BMT: A constantly changing field

Jeffrey Schriber, M.D., medical director of the City of Hope•Samaritan BMT Program and his colleagues, Joseph Alvarnas, M.D., and Clarence Sarkodee-Adoo, M.D., have seen many changes in bone marrow transplantation since the City of Hope•Samaritan BMT Program was founded.

"When we started, we only performed autologous BMTs, but presently we do all types of transplants including sibling allogeneic donor and matched unrelated donor (MUDs)," Dr. Schriber said. "In 1996, breast cancer was the largest group of patients transplanted. After critical studies in 1999, the number of breast cancer BMTs decreased tremendously. There is new data, however, that suggests that BMT will ultimately play an important role for selected patients with breast cancer."

BMT is a highly-specialized procedure that uses chemotherapy at very high doses and/or radiation to eliminate cancer cells. As a result of the intensive treatment, the patient's bone marrow is damaged and a new source of these cells must be provided. These cells can come from the patient themselves (autologous) or a donor (allogeneic). When the patient has been "rescued" through transplant, their new marrow is again able to produce the components of the blood and the immune system. BMT is used in the treatment of many cancers and chronic blood diseases such as acute and chronic leukemias, Hodgkin's disease, malignant lymphomas, multiple myeloma, breast cancer, ovarian cancer, testicular cancer, aplastic anemia and myelodysplasia.

"There is great pleasure in working with these patients to overcome a decidedly fatal disease through bone marrow transplantation," said Dr. Schriber. "This is a field where so much is happening every day and where the results of our research help ensure that our patients receive the latest treatments as soon as they are available. In just the past year, we have seen major advances in medicine, like Gleevec, and the development of less intensive transplants that are less harmful to elderly and critically-ill patients."

A major innovation has been the use of so-called non-myeloablative BMT for a variety of illnesses. This type, also called the mini BMT, uses lower doses of chemotherapy designed not so much to destroy the tumor but to suppress the immune system so that the new graft (from a donor) can take hold. The patient then relies on the graft-versus-tumor effect (where the new cell's immune system attacks any residual tumor cells) as the primary effective mechanism. This allows older patients and those whose organ function might have precluded a transplant in the past to receive a transplant. This is especially important since many of these diseases are more common in older patients.

Research efforts focus on attempts to define the role of transplant for a variety of diseases. "In general, the field has moved to trying to identify patients who are at higher risk and transplant them at that point, rather than waiting until relapse," Dr. Schriber said. "This approach appears to offer significantly greater chances for cure.

"The combination of an autologous transplant followed by a non-myeloablative transplant is one that is very interesting. This allows the patient's system to debulk with the first and mop up with the second. We think of it as a cleaning crew: you need the guys to do the heavy work before the fine work is effective, but both components are critical to overall success," Dr. Schriber added.

While the research may present exciting challenges in the upcoming years, Dr. Schriber said it's the patients and watching them return to everyday life without cancer that makes the work enjoyable. Some of the City of Hope•Samaritan's first breast cancer patients are now closing in on six years without the disease. A number of the program's recent patients who received allogeneic transplants have just hit their year marks; many of these patients had terrible diseases and would certainly have died without a transplant.

"There is one gentleman who had highly unusual complications and was hospitalized for a month unable to walk; he is now at work and running several miles a day," Dr. Schriber related. "Another of our MUD recipients is now volunteering for us."

The City of Hope•Samaritan Bone Marrow Transplantation Program has obtained marrow from almost 50 people for the National Marrow Donor Program; their marrow is currently benefiting patients all over the United States, Canada and even in Europe. "Within the 300 transplants we have affected not only the patients but their families," said Dr. Schriber. "Every patient has a wife or husband, kids or parents, and loved ones that they touch and are involved. We strive to treat not a patient but a person who has a disease that affects them and their entire world."

For more information on the City of Hope•Samaritan Bone Marrow Transplantation Program, please visit the Banner Health website, www.BannerHealth.com, or the City of Hope website at www.cityofhope.org.

For more information, or to contact City of Hope, see their website at: www.cityofhope.org