Andrews participated in Froedtert’s outpatient transplant
Stem cell and
bone marrow transplants have come a long way since the early 1970s
when physicians first began using the technique to treat patients with
advanced leukemia. Today, the life-saving therapy has been expanded to
treat other types of cancer that affect the blood, bone marrow and
lymphatic system, including non-Hodgkin’s lymphoma, Hodgkin’s
disease and multiple myeloma.
many patients are now eligible to receive bone marrow transplants on
an outpatient basis. Froedtert & The Medical College of Wisconsin
first implemented its outpatient bone marrow transplant program in
2009. That year, the outpatient transplant program treated 10
patients. In 2011, the most recent year for which statistics are
available, the hospital performed 155 bone marrow transplants on an
outpatient transplant program is the only one of its kind in the
Milwaukee area," says Dr. Parameswaran Hari, a
hematologist/oncologist and director of the Adult Blood and Marrow
Transplant Program at Froedtert & The Medical College of
chemotherapy and radiation are standard treatments in the fight
against leukemia, lymphoma and other types of blood and bone cancers,
but these aggressive therapies kill not only diseased cells but
healthy ones too. To replace the healthy cells and bone marrow damaged
during cancer treatment, patients often undergo a bone marrow or stem
That was the
course of therapy Matt Andrews followed. After being diagnosed with
peripheral T-cell lymphoma, a rare and usually aggressive form of
cancer, in October 2009, the 34-year-old Greenfield resident underwent
multiple surgeries to remove the tumor, followed by radiation then
high-dose course of chemotherapy, Andrews received an autologous stem
cell transplant — a process that uses stem cells harvested from the
patient’s own bone marrow — to replace the healthy, blood-forming
cells that had been destroyed. When his cancer resurfaced last fall,
Andrews had a second transplant as an outpatient — this time using
stem cells from an unidentified donor.
Comforts of Home
began offering bone marrow transplants on an outpatient basis, the
only option for patients in the Milwaukee area was an extended stay in
the hospital’s transplant unit — up to four weeks — because of
potentially life-threatening side effects. More recently, though,
research has shown that infection rates and outcomes do not vary
significantly whether people are treated as inpatients or outpatients,
according to a 2009 article in the journal Nature.
have the ability to return home during treatment rather than endure a
lengthy inpatient hospital stay.
"We like to
refer to our transplant program as home-based," explains Hari.
Receiving a bone
marrow transplant as an outpatient helps reduce patients’ costs,
which can run several hundred thousand dollars per transplant. But
there’s also evidence that patients recover faster at home.
know the exact reason why," says Hari. Anecdotally, though, he
has found that without the prolonged hospital stay his patients seem
to more easily transition back into their normal daily routine.
outpatients, people are able to maintain some control when cancer has
completely taken over their lives," he says.
"Being able to see my daughter and sleep in my own bed put me in
a better frame of mind," he says. "To be in my own
surroundings made a big difference."
outpatient allogeneic transplants, which use cells obtained from a
donor, on patients with aggressive cancers like PTCL is a relatively
new practice since there’s a higher risk of complication, such as
graft vs. host disease (a condition in which the donor’s
transplanted stem cells attack the patient’s body).
among the first patients in Froedtert’s outpatient transplant
program to undergo the procedure. Doctors considered him a good
candidate since he is relatively young and responded well to the
autologous transplant two years earlier.
Nearly a year
after undergoing his second outpatient transplant, Andrews hasn’t
had a recurrence of cancer.
people with PTCL have a high relapse rate, you’re never really
considered in remission," he explains.
uncertainty of his disease, Andrews is grateful to the doctors and
staff at Froedtert’s Cancer Center.
was absolutely great," he says. "It was the best experience
I could have hoped for."