Sutter Health Cancer Services and Programs

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B l o o d a n d M a r r o w Tr a n s p l a n t a t i o n P r o g r a m sProgramsat Sutter HealthAntoine Sayegh, MD, Medical DirectorBlood and MarrowTransplantation ProgramSutter Medical Center, SacramentoJeffrey Wolf, MD, Medical DirectorBlood and Marrow TransplantationProgram, Alta Bates SummitMedical CenterOver the past 21 years, the Blood and Marrow Transplantation (BMT) programswithin the Sutter Health network have provided successful advanced therapy for avariety of malignant and nonmalignant diseases. The programs at Alta Bates SummitMedical Center (ABSMC) and Sutter Medical Center, Sacramento (SMCS) haveperformed almost 800 transplantations, with results comparable to those seen atthe major cancer centers across the country and around the world. BMT offers hopeto many cancer patients who would otherwise face a very poor prognosis. Recentadvances in the field have made BMT an effective, life-saving treatment option and,in some cases, a first-line treatment choice.In 1984, Alta Bates established the first BMT program in Northern California. In1993, the BMT program at SMCS joined an already established solid organ transplantprogram at that facility. A single physician has directed each program sinceinception: Dr. Jeffrey Wolf at ABSMC and Dr. Antoine Sayegh at SMCS.In the late 1980s, the Alta Bates Cryopreservation Laboratory was established tosupport the BMT program, which had grown dramatically. As a fully accreditedindependent laboratory, it provides services to Children’s Hospital Oakland andits sister program at SMCS, as well as to the patients at Alta Bates. It also supportsthe nation’s only Sibling Cord Blood Program, receiving cord blood specimensfrom throughout the country, freezing them, and then providing them to transplantprograms around the world at the time of the transplant.In 1996, SMCS opened a completely new, family-focused, dedicated six-bed inpatientBMT unit. This unit, which is fully HEPA filtered throughout and has full criticalcare/telemetry capabilities, allows the SMCS BMT program to deliver the highestquality care to their patients throughout Northern California and the Central Valley.In 2003, the ABSMC BMT program became only the second BMT center in northernCalifornia to become fully accredited by the Foundation for the Accreditation of CellularTherapy (FACT). The program at SMCS received full FACT accreditationin 2005.28 | 2005 Annual Cancer Center Report — 2004 Statistical Review
B l o o d a n d M a r r o w Tr a n s p l a n t a t i o n P r o g r a m sBoth programs provide:• A multi-disciplinary team of health professionals tocoordinate patient care;• Specially trained, dedicated BMT nursing staff andcoordinators focused on continuum of quality care;• State-of-the-art facilities, including HEPA-filtered rooms tominimize the chance of infections;• A variety of counseling, educational and other supportservices, including comfortable, local lodging for out-of-town patients andfamilies;• Access to the latest collaborative national protocols through the SouthwestOncology Group; and• Efforts to advance the efficacy of BMT through the submission of data to theinternational BMT registry, the Combined International Bone Marrow TransplantRegistry.Kathy Albee, RN, BMT Coordinator, and Tony Saygeh,MD, BMT Medical Director.Clinical integration of the two programs includes coordinated efforts in a varietyof areas, including nursing education, protocol development, quality improvementand data management.How BMT WorksDepending on the disease being treated and the state of the disease in the patient,BMT functions in the following ways:• Corrects a deficient marrow state (or aplastic anemia);• Allows the patient to receive very high doses of chemotherapy and/or radiationtherapy (autologous); and• Provides the patient with a new immune system to replace a deficient one or tofight malignant disease (allogeneic).While the indications for BMT are always in evolution, BMT is primarily used insituations where conventional chemotherapy offers the patient little chance of cure.The following list is by no means comprehensive but details some of the diseasestreated:• Autologous BMT is indicated for recurrent lymphomas (such as Hodgkin’sand non-Hodgkin’s lymphomas), acute myeloid leukemia, multiple myeloma,recurrent testis cancer and rare other solid tumors (e.g., pediatric brain tumors).• Allogeneic BMT is used for all types of leukemia, inborn defects in immunecompetence and metabolism (sickle cell disease, for example), multiple myeloma,certain types of slow growing lymphomas, and conditions associated with bonemarrow failure, such as aplastic anemia, myelodysplasia and myelofibrosis.BMT involves the collection of hematopoietic stem cells (HSC) from the bonemarrow or the peripheral blood. Through a process called mobilization, bonemarrow stem cells can be moved into the bloodstream, thereby facilitating theircollection. The mobilization process is carried out by the injection of hematopoieticgrowth factors such as G-CSF. Recently, cord blood was found to be rich enough inHSC to support use in BMT procedures (predominantly in children).2005 Annual Cancer Center Report — 2004 Statistical Review | 29
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