Leading Bone Marrow Transplant Program Expands

At the Podium – October 2007

By Peter Westervelt, MD, PhD

Originally developed as a therapy for advanced leukemia, bone marrow or hematopoietic stem cell transplantation is now an established modality for treating a variety of hematologic malignancies, including lymphoma, multiple myeloma, nonmalignant conditions such as aplastic anemia and inherited disorders like sickle cell anemia.

In 1994, John DiPersio, MD, PhD, currently Siteman Cancer Center’s deputy director and chief of Washington University’s Division of Oncology, was recruited to lead the university’s bone marrow transplantation program. Over the decade to follow, he successfully built a program that combined top-notch specialists in the field, the latest clinical techniques and resources, and knowledgeable, experienced nursing care. A central focus of the program has been clinical trial development and enrollment, giving patients access to the latest advances in the field and fostering progress in basic, translational and clinical research.

Today, as a result of these efforts, the bone marrow transplantation program at Siteman and Washington University stands among the top five in the country and this year is on track to perform an unprecedented 300 transplants. In recent years, the pace of growth has taxed the capacity of the existing faculty and created an urgent need to recruit additional physicians to provide patient care and conduct research critical to advancing new therapies and understanding basic disease mechanisms.

In July 2006, I returned to Washington University at the invitation of Dr. DiPersio to become director of the Section of Bone Marrow Transplantation and Leukemia within the Division of Oncology. For me, it was for me an exciting homecoming of sorts since I began my training at the university, earning combined medical and doctoral degrees and completing a residency in internal medicine and a fellowship in hematology and oncology. I went on to serve as an instructor in the bone marrow transplantation program for two years before leaving to join the faculty at the University of Massachusetts Medical School in Worcester, where I subsequently assumed the role of director of the bone marrow transplantation program.

Over the past year, a major emphasis of our program has remained on recruitment and integration of new faculty. We have been extremely fortunate in the recent recruitment of four exceptional physicians, bringing our total to seven primarily clinical physicians and three primarily laboratory physicians. New clinical recruits include Camille Abboud, MD, previously at the University of Rochester; Keith Stockerl-Goldstein, MD, previously at Stanford University; Amanda Cashen, MD, previously a fellow at Washington University; and Geoffrey Uy, MD, also previously a fellow at Washington University. In addition to Dr. DiPersio and me, they join Ravi Vij, MD, a nationally recognized leader in the treatment of multiple myeloma and a member of the faculty since 2004.

We also benefit from the continued contributions of Timothy Graubert, MD; Michael Tomasson, MD; and, more recently, Matthew Walter, MD, all outstanding independent laboratory investigators. In addition to their clinical expertise, these faculty members provide an invaluable translational research link between the clinical program and ongoing basic science initiatives in Washington University’s Section of Stem Cell Biology under the leadership of Timothy Ley, MD, Siteman’s associate director for basic science.

This infusion of expertise not only enhances our ability to provide exceptional patient care, but it also enables us to take better advantage of a strength inherent in a transplant program of our size – a patient population large enough to facilitate single-institution clinical trials and provide access to a wide range of tissue samples for banking and future study. Paired with outstanding basic science expertise in stem cell biology, the bone marrow transplantation program is in an enviable position to continue to make significant contributions to the understanding of basic disease processes and improvements in therapies. Ongoing research spans a number of areas, including discovering ways to reduce the toxicity of the transplantation procedure by decreasing the incidence or severity of graft-versus-host disease; understanding how transplanted cells help fight leukemia cells to eliminate residual disease; developing new therapies for hematologic malignancies; and working to identify and understand the genetic mutations associated with acute leukemia.

In addition, our program continues to work with other transplant centers through participation in cooperative groups and research consortia. We are a leading member of Cancer and Leukemia Group B (CALGB) and the BMT Clinical Trials Network (CTN). Largely in recognition of the efforts of Dr. Vij, we were recently asked to join the Multiple Myeloma Research Consortium (MMRC), an organization of 13 leading U.S. academic centers that facilitates collaborative research between biotechnology and pharmaceutical companies and academic research institutions with the intention of creating new and effective treatments and ensuring progress toward a cure for multiple myeloma.

Heading into 2008, it is an exciting time to be part of the bone marrow transplantation program at Washington University. With a clinical and research faculty of unparalleled expertise, a traditionally strong core of dedicated, experienced nurses, and the unwavering support of the hospital system, we have never been in a better position to achieve our mission of providing outstanding, compassionate patient care while conducting the cutting-edge research that will translate into better care for our patients in the future.

Peter Westervelt

Peter Westervelt, MD, PhD, is associate professor of medicine and chief of the Section of Bone Marrow Transplantation and Leukemia at Washington University School of Medicine.

You can hear Dr. Westervelt as a guest on Cancer Connection, Siteman Cancer Center's podcast series.