With an enduring legacy of excellent outcomes, the Blood and Marrow Stem Cell Transplant Program is the destination of choice for patients with bone marrow disease in the San Antonio region and beyond.
Siblings Melody and Luke McCormick bravely battled HLH (hemophagocytic lymphohistiocytosis) at Methodist Children’s Hospital.
“Dr. Fred LeMaistre came to us from The University of Texas Health Science Center in 1993 and established our program,” says Paul Shaughnessy, MD, Program Director of Blood and Marrow Stem Cell Transplant at Texas Transplant Institute. “Since then, we have expanded to Austin, and we continue to grow our pediatric and adult services through outreach clinics, such as those offered monthly in McAllen and Corpus Christi.”
The Blood and Marrow Stem Cell Transplant Program performs adult and pediatric autologous and allogenic transplants and is one of the first in the nation accredited by FACT, the Foundation for the Accreditation of Cellular Therapy.
“With the support of Methodist Hospital, we have developed high standards of quality and foster very good outcomes for patients,” says Dr. Shaughnessy, who has been with the program since 2001. “Our FACT accreditation for both adult and pediatric bone marrow stem cell transplant indicates we meet national and international standards for excellent outcomes.”
The program is leading the way in many therapies, such as preserving multiple myeloma patients’ own bone marrow stem cells for use in autologous stem cell transplant following chemotherapy, a process that leads to increased remission and improved survival rates. The Blood and Marrow Stem Cell Transplant Program also offers complex procedures such as allogenic transplants for patients with acute or refractory leukemia or myelodysplasia. In these procedures, the patient’s immune system must be suppressed to accept the graft, and an appropriate donor must be located. Such patients are monitored for years after the procedure. In addition, the Blood and Marrow Stem Cell Transplant Program offers umbilical cord blood transplant and haploidentical transplants — advanced procedures for patients who do not have a perfectly matched donor.
“This has greatly expanded the use of bone marrow transplant to patients who might otherwise have died of their leukemia,” Dr. Shaughnessy says. “Haploidentical transplant is one of the great advances of the past few years, and we are getting very good outcomes for patients who had no other treatment option.”
“We have the only accredited bone marrow transplant program in the area, and we are very proud of that fact. We want physicians in the community to know they are welcome to contact us at any time.”
— Paul Shaughnessy, MD, Program Director of Blood and Marrow Stem Cell Transplant at Texas Transplant Institute
Difficult Cases, Excellent Results
Despite the fact that the most common conditions seen at the Blood and Marrow Stem Cell Transplant Program — multiple myeloma, non-Hodgkin’s lymphoma, refractory leukemia and myelodysplasia — provide multiple challenges to treatment, Methodist Hospital consistently performs competitively compared with similar programs.
“We’re extremely proud of our outcomes,” says Robert Lenza, CEO of Methodist Children’s Hospital and Women’s Services. “Every year we perform 30 to 40 pediatric bone marrow transplants and we’ve completed more than 650 since our program’s inception. For 2016, our one-year survival rate for autologous bone marrow transplant was 100 percent, and our one-year survival rate for allogenic transplant was 86 percent. We have former patients who are in their 30s and 40s now presenting in our survivorship clinics.”
The adult program has performed about 2,400 blood or marrow stem cell transplants since 1993.
“We like to be involved in a patient’s care early. Bone marrow transplant is a process, so the more information we can obtain about patients early on, the more potential benefit we can offer in terms of discussing whether a transplant is necessary or planning for it in the event it is needed.”
— Michael Eckrich, MD, MPH, Medical Director of Pediatric Blood and Marrow Transplant at Methodist Children’s Hospital
Texas Transplant Physician Group
Such excellent outcomes are made possible by the experience and expertise of Texas Transplant Physician Group oncologists and hematologists, who care for patients in blood and marrow clinics and in the hospital. These providers hold advanced, post-fellowship training in blood disease and bone marrow transplant.
Kids don’t stop being kids just because they have cancer. At Methodist Children’s Hospital, younger children can enjoy playing with toys or experimenting with arts and crafts while teens and adolescents have their own space for video games, movies or a game of pool!
“Our pediatric division is one of the busier in the country,” says Michael Eckrich, MD, MPH, Medical Director of Pediatric Blood and Marrow Transplant at Methodist Children’s Hospital. “Of our three pediatric physicians, I trained at Vanderbilt, Dr. Quigg [Troy Quigg, DO, MS] trained at Riley Hospital for Children (Indiana University School of Medicine) and Dr. Madden [Lisa Madden, MD, MS] comes with faculty experience from Washington University in St. Louis. Our providers are nationally recognized and bring expertise from the top institutions in the country to our program.”
The adult care providers are equally accomplished, with many holding leadership roles in Texas medical training facilities. Dr. Shaughnessy has been instrumental in developing the Blood and Marrow Transplant Program, while Jose Cruz, MD, served as director of the blood and marrow transplantation program at Texas Tech University Health Sciences Center as well as medical director of the BMT program at the Audie Murphy VA Center. Behyar Zoghi, MD, PhD, FACP, completed a fellowship at the Cancer Therapy and Research Center and is one of Texas’ leading teachers and researchers in hematology/oncology.
These providers are eager to collaborate with primary care providers and oncologists throughout Texas.
“One of our key features is how we communicate directly with our referral physicians,” Dr. Eckrich says. “When providers select us for the care of their patients, we like them to know we are committed to partner with them for those patients’ care. Many patients have ongoing needs after transplant, and we work closely with referring providers to address those concerns.”
A Wide Research Network
Thanks to a collaboration with Sarah Cannon, HCA Healthcare’s cancer research institute, Methodist Hospital’s Blood and Marrow Stem Cell Transplant Program can collaborate with similar programs across the nation to develop therapies for bone marrow disease. This partnership allows patients to access numerous clinical trials.
“Sarah Cannon offers us new drugs and new approaches to using drugs,” Dr. Shaughnessy says. “Access to large clinical trials lets us provide treatments to patients with relapsed or refractory leukemias in order to help them reach transplant. We can offer these therapies close to home, with no need for patients to travel.”
“We have 17 open clinical trials in bone marrow therapy,” Lenza adds. “We are glad to collaborate with Sarah Cannon to develop best practices and clinical pathways to make sure patients are getting the best care available.”
Care for the Whole Patient
The process from chemotherapy to transplant to recovery for adult and pediatric bone marrow disease patients can be exceptionally time-consuming. Patients may spend weeks or months in the hospital. During that time, Methodist Hospital looks after each patient as a whole person, addressing needs for the body, mind and spirit.
Bone marrow transplant patient, Luke McCormick, patiently awaits his chemotherapy treatment at Methodist Children’s Hospital.
“We offer a wide variety of services, from weekly support groups run by patients and families to national programs such as Beads of Courage in which children get a bead for each treatment or other important event in their medical journey,” Lenza says. “We have clinical psychiatric support, a psycho-social team and Child Life specialists, who are professionals trained to use medical play to help children understand what’s going on with their illness.”
Methodist Children’s Hospital does everything it can to reassure young patients, such as using a virtual reality program to let children better understand MRI and other procedures prior to experiencing them. Other programs include pet therapy, art therapy and music therapy. The hospital works with teachers to help child and adolescent patients keep up with their studies during treatment.
Unique Service to Unite Youth and Young Adults
Soon, a new program will launch, making Methodist Hospital’s Blood and Marrow Stem Cell Transplant Program unique in the country: the Adolescent and Young Adult (AYA) pilot program, bridging pediatric and adult populations. Supported by Sarah Cannon, this program will serve patients united by similarities in their disease across child and young adult populations. This pilot endeavor will build on the collaborative strengths of the pediatric and adult programs at Methodist Hospital, which have long resisted building silos around bone marrow transplant care. The program will also support AYA patients as they deal with concerns common to teens and young adults: finishing school, becoming independent decision-makers and facing the challenges of moving into adulthood while coping with cancer treatments.
“When I first started, I was directing outpatient clinics and I saw a little girl riding a scooter up and down the hall. She was completely bald, but she was wearing a pink dress and a ribbon around her head. She was a survivor. All she wanted was to be a kid, despite what the disease threw at her. Our patients are children — they are not their diseases. And often, when we see them at age 40 or beyond, they’re still thriving.”
— Robert Lenza, CEO, Methodist Children’s Hospital and Women’s Services
“We understand from the data that there is a range of patients who often can do better with pediatric clinical trials,” Dr. Eckrich says. “We can build and develop a program that will benefit all young adult patients who might be eligible for and receive benefit from a transplant.
“In terms of life goals, we aim to meet patients where they are,” Dr. Eckrich continues. We have some enrolled in college, and transplant can force them to put that on hold. One thing critically different about adolescent and young adult patients is they are fostering their own independence. We look to support that process within a family-focused environment, bringing to bear every resource we can to support our patients’ ambitions for when they return to health after transplant.”
Visit methodistbmt.com or call 210-575-2222 for more information.