Veteran Receives Bone Marrow Transplant as an Outpatient

U.S. Navy veteran Tracey Lynch spent more than two decades serving her country. As a Torpedoman’s Mate in the military, she expected a bit of risk in her life. This attitude was vital in facing a cancer diagnosis.

“I always try to keep a positive attitude about everything,” says Tracey, who was in her early 50s when she learned she had multiple myeloma. Referred for a bone marrow transplant, she was grateful that receiving this treatment on an outpatient basis was an option. Historically bone marrow transplant, in which UH was a pioneer nearly half a century ago, requires patients to remain in the hospital for weeks after the stem cells are transfused into the patient to reduce risk of infection.

The Painesville resident stayed at the nearby Hope Lodge during her transplant outpatient visits. “I liked the fact that I wasn’t trapped in a hospital room and could just walk to the hospital,” said Tracey, who is no stranger to the fight, having faced uterine and cervical cancer 15 years earlier.

What is Multiple Myeloma?

Multiple myeloma is among the blood cancers for which an autologous bone marrow transplant of a patient’s own cells is the standard of care. It is a cancer of plasma cells, which are found in the bone marrow and, under normal circumstances, make antibodies. It also can cause low red blood cell counts, can damage the bones and the kidneys, and can increase the level of calcium in the blood.

These symptoms and signs of multiple myeloma can be present at diagnosis. Tracey presented with low blood counts and a monoclonal antibody (M-protein) in her blood. Last year, she grew concerned when extreme fatigue and bone pain in her back and knees began interfering with her daily life. After a bone marrow biopsy, she was diagnosed with myeloma at the Cleveland VA and referred to UH for an autologous stem cell transplant.

Incurable but Treatable

“Multiple myeloma is considered to be an incurable blood cancer,” said Leland Metheny, MD, the hematologist taking care of Tracey. “The focus of cancer therapy in this disease is to prolong the time period where the disease shows no activity in the blood or bone marrow or damage being done to other organs. We get the disease under control, then offer an autologous bone marrow transplant after initial chemotherapy to provide the best chance of getting the disease under control for the longest period of time.

“I always tell patients it’s really a trick. We take a purified bag of their own blood-making stem cells, then blast the patient with a very large dose of melphalan, an effective chemotherapy against multiple myeloma. Then, when the melphalan is out of the system after a couple hours, we give them their own cells back to rescue the patient from their own hematologic toxicity.”

Innovative Approach to Bone Marrow Transplant

UH worked with pharmacy and nursing to establish an outpatient bone marrow transplant program in a dedicated space on the second floor of UH Seidman Cancer Center. After the initial transplant, which takes up to eight hours, the patient can leave the hospital and return daily for labs and assessment. If their blood counts go down, they are given a blood transfusion. Tracey was impressed with the caregivers on the infusion floor, who were all thorough, personable and professional, answering all her questions and ensuring her safety and comfort.

With 10-15 days, when their red and white blood cells and platelets start growing, patients’ physical symptoms start improving. Patients have told Dr. Metheny they appreciate being able to go home. And they avoid potential complications that inpatients everywhere contend with, such as hospital-acquired infections.

Dr. Metheny is pleased with Tracey’s progress.

“She is an excellent patient,” Dr. Metheny said. “She’s recovered her blood counts and has no significant organ dysfunction.”

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The hematology and oncology experts at University Hospitals Seidman Cancer Center offer innovative, patient-centered care for the treatment of all types of cancer, including multiple myeloma.