The University of Nebraska Medical Center/Nebraska Health System recently
reached a milestone in its treatment of patients with non-Hodgkins lymphoma.
On Oct. 19, Andrew Rowe, 47, of Overland Park, Kan., became the 1,000th
non-Hodgkins lymphoma patient to receive a transplant at UNMC/NHS. Rowe
received an allogeneic stem cell transplant using stem cells donated by
his 48-year-old brother, Daniel, who lives in Denver.
This is a significant marker in our mission to treat patients with
the latest and most effective methods available, said Phil Bierman, M.D.,
a UNMC College of Medicine faculty member and an oncologist with NHS, UNMCs
health sciences partner.
UNMC first used a bone marrow transplant to treat a non-Hodgkins lymphoma
patient in 1983, a year after James O. Armitage, M.D., began the lymphoma
program at UNMC. Non-Hodgkins lymphoma is a malignant (cancerous) growth
of B or T cells in the lymph system. There are about 56,000 cases of the
disease diagnosed nationwide each year, eight times as many as Hodgkins
disease cases.
Since UNMC/NHS treated its first patient, many changes have occurred
in the way the health sciences center administers the transplants.
Initially, all transplants were autologous, meaning a patients own
bone marrow was used. Early transplant recipients were put under general
anesthesia while physicians extracted the patients bone marrow through
large needles that were inserted into the hip bone. After the patient underwent
high-dose chemotherapy, the bone marrow was then re-introduced into the
patient.
Today, most patients undergo a procedure before they receive chemotherapy
that resembles giving blood at a local Red Cross. During the initial procedure,
blood is taken from a patient, filtered to isolate and capture peripheral
stem cells and then returned to the patient.
After a patient undergoes chemotherapy which kills the cancerous cells
along with the bodys useful cells the stem cells are re-introduced into
the patient. Those stem cells then rebuild the patients immune system,
with the assistance of specific drugs commonly called growth factors.
In addition to providing greater comfort to the patients, todays procedures
also are less expensive because the patient spends much of his or her time
recovering in the Lied Transplant Center, as compared to recovering within
the hospital. The Lied Center, which opened in 1999, was the first treatment
facility to use cooperative care, a concept that includes a designated
family member or friend to help tend to the patients needs during treatment
and recovery.
Theres no way, 17 years ago, that anyone would have thought that wed
be doing transplants using the mechanisms we use today, said Dr. Armitage,
who still treats patients in addition to his administrative duties as dean
of the UNMC College of Medicine. Its a tremendous credit to the advances
in medical science and, more specifically, the initiative, ingenuity and
hard work of the UNMC transplant team.
The technique using peripheral stem cells was pioneered by Anne Kessinger,
M.D., an oncologist and associate director of the UNMC Eppley Cancer Center.
Dr. Kessinger first used the technique in 1984, and by 1992, UNMC had begun
to perform more stem cell transplants than those using bone marrow.
Dr. Kessingers work with stem cell transplants was ground-breaking,
Dr. Bierman said. Worldwide, she really is seen as the pioneer in this
means of transplantation.
Other milestones in UNMCs treatment of non-Hodgkins lymphoma include
· Formation of the Nebraska Lymphoma Study Group in 1982. The
group is an ongoing, statewide collection of oncologists, pathologists
and other health-care professionals who provide clinical and tissue samples
of lymphoma patients for analysis at UNMC. The collaboration improves diagnostic
and treatments methods.
· Establishment of a pediatric bone marrow transplant program
in 1987.
· Joining the National Comprehensive Cancer Network a network
of 13 of the nations leading cancer centers, in 1995.
We have achieved much over the past 20 years, but work remains to be
done, Dr. Armitage said. Lymphoma still affects a great many people all
over the world. The disease is the enemy, and we will use our expertise
to research and practice the best ways to treat and defeat it.
Rowe, the 1,000th transplant recipient, was first diagnosed with non-Hodgkins
lymphoma in December 1998. He was treated in Kansas City with chemotherapy,
but his disease recurred in February 2000, necessitating his journey to
UNMC/NHS for his transplant.
A professional public speaker who presents business seminars around
the country for Padgett Thompson, Rowe and his wife, Chris, have been married
for 24 years. They have two children Beth, 19, and J.D., 14.