Post on 18-Jun-2018
We were one of the
first centers in the
world to routinely
offer patients
blood and marrow
transplantation (BMT).
The Blood & Marrow Transplantation Center
What Sets Us Apart• High-volume center performs about 150
transplants per year.
• Better-than-predicted outcomes for patients receiving allogeneic transplants.
• Access to clinical trials, both cooperative group and investigator-initiated.
• A full menu of services, from Caregiver Orientation to Long-Term Survivorship Clinic.
• Prompt evaluation, within one week of referral (24 hours for critical cases).
Partners In Practicewww.roswellpark.org/partners-in-practice
medical information for physicians by physicians
Specialized Multidisciplinary Care
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A Center Designed for Safety and ComfortRPCI can accommodate more than 20 BMT inpatients at one time. Private
patient rooms feature High-Efficiency Particulate-free Air (HEPA) filtration
to protect against airborne infections, a private bathroom, TV with DVD
player, and a convertible easy chair so a loved one can stay overnight.
Visitors (usually two at a time) are welcome 24 hours a day, seven days a
week, and may relax, do laundry, or fix a snack in the adjacent solarium.
Outpatients are seen in a dedicated BMT outpatient center in the hospital.
OUR TEAM INCLUDES:Transplant physicians
Advanced practice practitioners(nurse practitioners and physician assistants)
Transplant unit nurses
Transplant coordinators
Infectious disease physicians
Dedicated specialty physician consults
Dietitians
Clinical pharmacists
Psychologists
Medical social workers
Nurse case managers
Physical and occupational therapists
Respiratory therapists
Dentists
Financial counselors
Pastoral Care staff
Patient advocates
RPCI’s BMT Center brings together a multidisciplinary team of specialists
in transplant, radiation, surgery, infectious disease, dentistry, cardiology,
and pulmonary, renal, and gastrointestinal medicine, as well as nutrition and
psychosocial support. Nursing staff are specialty-trained in the management
and care of immune-compromised BMT patients.
Team members
collaboratively
develop a comprehensive
treatment plan for
each patient, meeting
daily to review
patient progress
and status.
Our BMT Center provides both autologous transplantation, using the patient’s own hematopoietic
stem cells harvested from peripheral blood or bone marrow, and allogeneic transplantation, using a donor’s peripheral blood, bone marrow, or cord blood. Our dedicated facility also provides these
Specialized Transplant Services:ADULT PATIENTS
PEDIATRIC PATIENTS
RPCI offers BMT for eligible pediatric patients between ages 4 and 18 for these diseases:• Hemophagocytic lymphohistiocytosis (HLH)
• Leukemia
• Lymphoma
• Aplastic anemia, Fanconi anemia,
and other marrow-failure syndromes
• Myelodysplastic and myeloproliferative disorders
• Sickle cell disease
• Thalassemia
• Malignant brain tumors
• Neuroblastoma
RPCI offers BMT for eligible adult patients between ages 18 and 80 for these diseases:• Acute lymphocytic leukemia
• Acute myeloid leukemia
• Aplastic anemia and other marrow-failure
syndromes
• Chronic lymphocytic leukemia
• Chronic myelogenous leukemia
• Non-Hodgkin lymphoma
• Hodgkin lymphoma
• Multiple myeloma
• Myelodysplastic syndrome
• Myeloproliferative neoplasms, including myelofibrosis
• Selected solid tumors (malignant), such
as testicular cancer
• Hemoglobinopathies, including sickle cell
disease and thalassemia
Comprehensive Transplantation Treatment
• Reduced-intensity conditioning and non-myeloablativetransplant, which can make transplant possible for eligiblepatients up to age 80, depending on patient fitness
• Onsite collection and processing of blood and marrow
• World-class flow cytometry and laboratory support services
• Unrelated donor BMT
• Cord blood transplant for patients who do not have a fully matched donor, either related or unrelated
• Haplo-identical related BMT for patients who do not have a fully matched donor
• Promising new methods of predicting and controlling transplant complications, including treatment side effectsand Graft-versus-Host Disease
• Quality Management Program to ensure consistent highquality in clinical care, cell collection and processing atevery stage of the transplant process
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Tracy RoachPatient Access Coordinator
Sarah RiggieSenior Patient Access Representative
Talk to one of our patient access specialists at 716-845-4717
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Tota
l Num
ber o
f BM
Ts
Number of BMTs per Year Allo Auto
Calendar Year
200
150
100
50
0
2003 2004 2005 2006 2007
nda
2008
aaarrr
2009 2010 2011 2012 2013
Our Patient Outcomes A high-volume center, RPCI performs about 150 transplants per year
For the fourth consecutive year, one-year survival outcomes for patients receiving allogeneic transplants through RPCI’s
BMT Center were shown to be significantly better than would be expected for the patient population treated. Outcomes were
evaluated on the basis of data from 168 U.S. transplant centers, published by the Center for International Blood and Marrow
Transplant Research (CIBMTR), for transplants performed between 2009-2011.
The risk-adjusted one-year survival rate for transplant patients at RPCI was much better than predicted. The CIBMTR assigned
the RPCI program to the highest possible risk category, indicating that RPCI’s BMT cases for the period were among the most
complex and difficult in the nation.
RPCI’s BMT Outcomes for Multiple Myeloma Patients
Between 2007-2013, Roswell Park’s BMT
program performed 112 first autologous
peripheral blood stem cell transplants
(PBSCTs). All 112 patients (100%) were
alive 100 days after PBSCT, and 94%
were alive one year after PBSCT.
Early referral is essentialFor an estimated 15% of patients evaluated by our team, referral comes late, resulting in increased mortality or the inability to undergo transplant. Preparation for transplant can take weeks—time to find a suitable donor (or collect the patient’s own stem cells), gain insurance approval, identify caregivers for post-transplant care, and prepare the patient.
If your patient is currently under treatment or in remission, referral for BMT evaluation isimportant. Your patient can begin preliminary steps, donor search and collecting and storingstem cells. This expedites treatment should your patient require a transplant in the future.
Lifetime Lifeline:Roswell Park’s BMT Long-Term Survivorship Clinic
Our BMT Center is one of few to offer a long-term clinic
for specialized follow-up care and monitoring for disease
recurrence, secondary malignancy, treatment-related
complications, and Graft-versus-Host Disease (GvHD).
The clinic is open to all RPCI transplant patients as a first
priority. Patients who received transplants at other centers
may also be evaluated at the long-term clinic.
It is expected that all patients will continue to see their
primary care physicians and referring oncologists for
general care. RPCI keeps patients’ physicians apprised
of their patients’ health during the transplant process
and beyond.
Appointments in the Long-Term Clinic are scheduled for Fridays.Call 716-845-1444 and follow the prompts for Annual Clinic.
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The Long-Term Clinic provides:• Clinical recommendations for the unique
complications that can result after BMT, including:
� Premature bone loss (osteopenia and osteoporosis)
� Dental problems and mouth sores
� Cataracts
� Thyroid changes
� Cardiac problems, hypertension,
hypercholesterolemia
� Pulmonary problems
� Infertility
� Lack of stable engraftment
� Side effects of corticosteroid use
� Skin changes
� Alopecia
� Nausea, vomiting, or diarrhea
• Specialty referrals for gastrointestinal, renal,
pulmonary, and dermatologic problems
• Dental health monitoring and recommendations
for long-term dental care
• Bone density surveillance of patients receiving
glucocorticoid therapy, who are high risk for premature
osteoporosis
• Re-immunization tracking for patients who have
undergone allogeneic BMT
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Cancer Pain Management Service (CPMS) develops a customized pain-management plan for every patient,
drawing on the expertise of physicians, anesthesiologists,
nurses, physical and occupational therapists, psychologists
and social workers. Options include both medical and
invasive procedures, biofeedback, relaxation training,
and physical therapy. RPCI upholds the high standards
of the National Comprehensive Cancer Network’s pain-
management protocols.
BMT Caregiver Orientation prepares patients and their
caregivers for every aspect of the transplant, including:
post-transplant medical needs; finances; coping strategies
for emotional, physical, and sexual issues related to BMT;
spirituality; and unique problems experienced by BMT
caregivers. The patient and family receive a personalized
care manual for later reference.
Financial counselors and Medicaid advocates help
patients understand their insurance coverage, including
participation in clinical trials. They work with third-party
payers to secure authorizations and serve as advocates
for patients, including patients from outside the U.S.
RPCI does not deny services to the uninsured.
For more information: Psychosocial Oncology Department, 716-845-8022.
Case managers and social workers help with such
issues as day-to-day household management, and travel
and lodging for out-of-town patients, who will be away
from home for several months during and post-transplant.
Support groups are open to patients, family members,
and caregivers at all stages of the transplant process.
For information: Psychosocial Oncology Department,716-845-8022.
RPCI Resource Center for Patients and Families offers
free cancer-related publications, access to computers/
Internet, and connection to reliable information about
cancer diagnosis and treatment. The Center also houses
a lending library of books, laptops, DVDs, and a boutique
of free wigs, hats, and scarves.
Helping
patients cope
with the
anxiety and
stress of
diagnosis and
treatment
Supportive CareRPCI surrounds patients and their families with a strong system of support before, during and after transplant.
Our Psychosocial Oncology and interfaith Pastoral Care departments help patients cope with the anxiety and
stress of diagnosis and treatment. Medical psychologists, social workers, chaplains, and spiritual advisors are
available at any hour for urgent needs. Our program includes:
Accreditations/Distinctions/Memberships
RPCI’S BLOOD AND MARROW TRANSPLANT PROGRAM HOLDSTHESE DISTINCTIONS:
• Certified for more than a decade by theFoundation for the Accreditation of Cellular Therapy (FACT) as meeting or exceeding global standards in patient care and laboratory services
• Core member, Blood and Marrow Transplant Clinical Trials Network (BMT-CTN) of the National Institutes of Health
• Certified by the National Marrow DonorProgram (NMDP) as a Transplant, Collection,and Apheresis Center
• Designated as a transplant center by the Alliance for Clinical Trials in Oncology(The Alliance), formerly the Cancer and Leukemia Group B (CALGB)
• Designated a Blue Distinction Center forComplex and Rare Cancers and for Bloodand Marrow Transplant by the BlueCrossBlueShield Association.
• Member of the National ComprehensiveCancer Network (NCCN)
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RPCI’S BMT PHYSICIANS ARE MEMBERS OF:� The American Society of Blood & Marrow Transplantation (ASBMT)
� The American Society of Hematology (ASH)
� The American Society of Clinical Oncology (ASCO)
� The American Association for Cancer Research (AACR)
Our Research Expands Treatment Options About 40% of our BMT patients are enrolled on investigator-initiated or cooperative group clinical trials. RPCI is an active member of:
� Transplant Committee of the Alliance for Clinical Trials in Oncology
Foundation (The Alliance—formerly Cancer and Leukemia Group B)
� Blood and Marrow Transplant Clinical Trials Network
� Chronic Graft-versus-Host Disease Consortium
� Pediatric Blood & Marrow Transplant Consortium
� Children’s Oncology Group
Search open clinical trials at roswellpark.org/clinical-trials
A few examples of our current research
• An NIH-funded Genome-Wide Association Study (GWAS) on 3,500 donor- and
recipient-unrelated donor pairs undergoing allogeneic transplant— With the Center
for International Blood and Marrow Transplant Research, National Marrow Donor Program,
and collaborators at the University of Southern California and University of Chicago
• Translational research: an investigation of the utility of Toll-Like Receptor (TLR)
agonists in pre-clinical hematopoietic stem cell mobilization and immune modulation,
to be translated into clinical BMT applications— With Cleveland BioLabs
• A pilot study of reduced-intensity transplant to determine if a novel conditioning
regimen will lead to better outcomes in allogeneic transplant — With the RPCI Radiation
Oncology Department
• A study examining novel approaches to the evaluation and treatment of chronic
Graft-versus-Host-Disease (GvHD) — With Stanford University Medical Center
Mining RPCI’s rich database of BMT dataWe maintain a comprehensive database of critical information about the approximately
2,000 transplants performed to date at RPCI. The database is managed by a clinical
epidemiologist who monitors our outcomes to develop new protocols, improve clinical
care, and identify better ways to manage long-term survivors.
THAT’S WHY AT’S WHY AROSWELL PARK PWILL NEVER STOP FIGHTING
WE CAN’T LET CANCER WINElm & Carlton Streets | Buffalo, New York 14263
www.RoswellPark.org/rpmd716-845-RPMD (716-845-7763)
A National Cancer Institute-Designated Comprehensive Cancer CenterA National Comprehensive Cancer Network Member
A Blue Distinction Center for Complex and Rare Cancers®
A Blue Distinction Center for Transplants®
An ANCC Magnet®-Designated Hospital
Medical OncologyPhilip McCarthy, MDDirector, BMT ProgramGeorge Chen, MDMaureen Ross, MD, PhDBarbara Bambach, MD, Pediatric BMTMeghan Higman, MD, PhD, Pediatric BMT
EpidemiologyTheresa Hahn, PhD
Transplant Program AdministratorStephen Schinnagel, MS
ImmunologyXuefang Cao, MD, PhDMichael Nemeth, PhDElizabeth Repasky, MD
Molecular & Cellular BiologyJoseph T. Y. Lau, PhD
PathologyJoanne Becker, MDPaul Wallace, PhD
Advanced Practice PractitionersMolly Aungst, NPJustine Bertolo, NPEric Breitwieser, PAMichelle Burgess, PAMelissa Everett, PAJennifer Grimmer, NPAmber Kobel, RN, MSN
Transplant CoordinatorsDana Cipolla, RN, BSNKaren Dubel, RN, CHTCPatricia Lipka, RN, BSN, CHTCColleen Warren, RN, AASLora Yoerg, RN, BSN
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Early referral is essentialAbout 15% of patients who come to Roswell Park to be evaluated
for BMT cannot undergo transplant, because they were referred too
late. Preparation for transplant takes time. Even if your patient is
currently in treatment or in remission, immediate referral is advised
so everything will be in order if BMT is needed in the future.
To refer a patient, contact:Tracy Roach, Patient Access Coordinator, or Sarah Riggie, Senior Patient Access Representative716-845-4717 28013 (8/14)
Meet the Team
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