For patients undergoing chemotherapy, even a slight fever can signal the beginning of a potentially life-threatening infection.  Methodist Hospital’s Very Immunocompromised Patient (VIP) Oncology program means ER staff is specially trained to identify and address the unique needs of chemotherapy patients. Click the link to download the VIP Oncology flyer and ask your hematologist/oncologist for more details.

Partnering with Hematologists/Oncologists in the community, Methodist Hospital is developing a Hematological Malignancy Program in collaboration with HCA and Sarah Cannon Research Institute.

The vision of the Hem Malignancy Program is for Methodist Hospital to be recognized by patients and physicians as the premier facility for the care of patients with aggressive blood cancers.

Six abstracts have been accepted to the 2011 ASH Meeting:

Upfront Tandem Autologous Stem Cell Transplant Is Superior to Autologous or Allogeneic Stem Cell Transplant After Failure of a 1st Autologous Transplant

Adrian Wong, MD, Charles F. LeMaistre, MD, Paul Shaughnessy, MD and Carlos Bachier, MD

Texas Transplant Institute^**(TTI), San Antonio, Texas

Summary

Stem cell transplant is now the standard of care for most patients diagnosed with multiple myeloma.  Patients can be candidates for either autologous (using their own stem cells) or allogeneic (using stem cells from a donor) transplants.  Allogeneic transplants are more effective against multiple myeloma but are also more risky and associated with more complications.

Investigators from TTI compared outcomes of patients undergoing both autologous and allogeneic transplants and found that autologous transplants were associated with longer survival.

Mismatches in Ethnicity Between Donor and Recipient Affects Overall Survival In Umbilical Cord Blood Transplantation

Patali Shikhi Cheruku, Veronica H. Jude, MD, Renee M Madden, MD, Charles F. LeMaistre, MD, Ka Wah Chan, MD, MBBS, Paul Shaughnessy, MD and Carlos Bachier, MD

Texas Transplant Institute^**, San Antonio, Texas

Summary

When a newborn is delivered the placenta is discarded. Blood extracted from the placenta is rich in the stem cells needed for bone marrow transplants. Transplants using this source of stem cells are known as umbilical cord blood transplants.

The number of cells extracted from the placenta and the match between the newborn (placenta) and the transplant patient determine the outcome of umbilical cord blood transplants.

Researchers at TTI evaluated the role of matching the ethnicity of the mother of the newborn from whom the umbilical cord blood was extracted and the transplant patient.  The researchers found that ethnicity matching affected overall survival in patients undergoing umbilical cord blood transplant. This effect was especially important in Hispanic patients. The large number of Hispanic patients transplanted at TTI made the analysis of the effect of ethnicity possible.

High Correlation of Pre-Apheresis Peripheral Blood CD34+ Cell Counts with Final Apheresis Product CD34+ Cell Count by Using a More Accurate Determination of Patient Blood Volume

Brandon Parker, James Hastings, Jill Folkert, RN, Gayla Nagy, RN, Carlos Bachier, MD, Charles F. LeMaistre, MD and Paul Shaughnessy, MDTexas Transplant Institute, San Antonio, TX

Methodist Hospital, Texas Transplant Institute, San Antonio, TX

Summary

Collecting bone marrow stem cells from the peripheral bloodstream requires complex medical care including injections of drugs to stimulate the stem cells in the bone marrow, placing specialized catheters into large veins, and then hours of processing the blood to remove the stem cells from the blood and then return the blood to the patient. 

Researchers at Methodist Hospital and TTI^** reviewed hundreds of patients undergoing stem cell collections and found that they could derive a formula to more accurately predict the patient’s blood volume. They then used this formula to see how accurately they could predict the number of stem cells collected based on the number of stem cells measured in a sample of blood before the collection even began. The predicted results and the actual results of the stem cell collections matched very closely. 

The researchers believe that being able to predict the number of stem cells collected before the procedure ends may allow some patients to have fewer injections of drugs and to remove the catheters from their veins sooner which will improve the safety and cost effectiveness of the procedure.

Chemo-Mobilization Provides Superior Mobilization and Collection in Autologous Stem Cell Transplants but with Less Predictability and at a Higher Cost

Nelson J. Chao, MD, Daniel T Grima, M.Sc., George Carrum, MD, Leona Holmberg, MD., PhD, Henry C. Fung, FRCP, MD, Stephen Brown, Ph.D., Mitchell E. Horwitz, MD, Lisa M Bernard, M.Sc., Junya Kanda, MD, Jane L. Liesveld, MD, Brian McClune, DO, Paul Shaughnessy, MD and Guido J. Tricot, MD, PhD

Summary

Researchers at TTI contributed patient data to a large national, retrospective study of how patients’ bone marrow stem cells are collected from the blood. Bone marrow stem cells can be released into the bloodstream of patients where they can be collected more easily after administering chemotherapy followed by a growth factor injection called G-CSF. Sometimes the G-CSF injection can be used without the chemotherapy. 

This large study sampled many transplant centers across the United States to evaluate the differences in how stem cells are mobilized and collected.  The study found that chemotherapy and G-CSF resulted in more stem cells being collected but there was a trade-off in more toxicity after the chemotherapy.

Differences in Stem Cell Collection Practices and Related Outcomes Between Centers That Conduct and Do Not Conduct Aphaeresis on Weekends

Nelson J. Chao, MD, Lisa M Bernard, M.Sc., George Carrum, MD, Henry C. Fung, FRCP, MD, Daniel T Grima, M.Sc., Leona Holmberg, MD., PhD, Stephen Brown, PhD, Mitchell E. Horwitz, MD, Junya Kanda, MD, Jane L. Liesveld, MD, Brian McClune, DO, Paul Shaughnessy, MD and Guido J. Tricot, MD, PhD

Summary

Researchers at TTI participated in a large national retrospective review of their practice patterns for mobilizing autologous bone marrow stem cells into the bloodstream and collecting them in a process called apheresis. 

The study found significant differences in practice patterns based on whether the collection center was open on the weekends. Weekday-only centers were more regimented and may have missed the peak stem cell collection day compared to the sites that used weekends. 

Stem cell collection success appears to be superior in centers that allowed stem cell collections to occur on weekends and these centers used more chemotherapy-based regimens to mobilize the stem cells into the bloodstream.

Allogeneic Hematopoietic Cell Transplantation (HCT) for Neuroblastoma (NB): The CIBMTR Experience

Gregory A. Hale, MD, Stephan A Grupp, MD, PhD, Kimberly A. Kasow, D.O., Michael R. Bishop, MD, Menachem Bitan, MD, PhD, Richard Childs, MD, Edward A. Copelan, MD, Mitchell S. Cairo, MD, Bruce Camitta, MD, Ka Wah Chan, MD, MBBS, Stella M. Davies, MBBS, PhD, Miguel A. Diaz, MD, John J Doyle, MD, Robert Peter Gale, MD, PhD, DSc, Vicent M. Gonzalez, MD, Biljana N. Horn, MD, Sonata Jodele, MD, Naynesh R. Kamani, MD, Hillard M. Lazarus, MD, FACP, Victor A. Lewis, MD, Kasiani C. Myers, MD, Michael A. Pulsipher, MD, Muna Qayed, MD, MSc. Jean Sanders, MD, Peter J. Shaw, MA, MB, BS, MRCP, FRACP, Sandeep Soni, MBBS, Edward A. Stadtmauer, MD, Patrick Stiff, MD, Donna A. Wall, MD and Mukta Arora, MD

Summary

Children with metastatic neuroblastoma have a grim prognosis. The current treatment approach includes chemotherapy and surgery to reduce the tumor burden (remission). At that point, administration of high-dose chemotherapy followed by an infusion of autologous (the patient’s own) stem cells improve the overall outcome.

Some children can be treated with stem cells from family members or unrelated donors. This transplant strategy may reduce disease relapse and improve survival in selected patients. Physicians at Texas Transplant Institute^** evaluate high-risk neuroblastoma individually and provide the type of transplant treatment that offers the best possibility of success.

Top North American experts in AYA cancer issues meet for the second time in San Antonio to discuss a variety of issues critical to improving the survival and well-being of this poorly understood and often ignored group.

Presentations to include:

Fertility Preservation

Psychosocial Issues

Epidemiology/Genetics

Survivorship

The conference also features a community event, “Keep Cancer Lame”, at The Cove with live music, a survivorship panel and guest speaker LIVESTRONG’s Heidi Adams.