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Hematologic Cancers

Advancing treatments with patients in mind

Melissa L. Larson, MD, and Parameswaran Venugopal, MDBeing diagnosed with a hematologic cancer — the group of cancers that includes leukemias, lymphomas and myelomas — often generates a long list of serious questions. And for most patients, a few rise to the top: What is my prognosis? What kinds of treatment will I need? And how will they affect me?

Thanks in part to the efforts of researchers and physicians at the Rush University Cancer Center, the answers to these questions continue to change for the better. New treatments and models of care for cancers of the blood, lymph nodes and bone marrow promise to improve both prognoses and patients' quality of life.

Targeting cancer cells

"Many lymphomas have been turned into chronic diseases," says Stephanie A. Gregory, MD, director of The Coleman Foundation Comprehensive Lymphoma Clinic, which recently opened as part of the Rush University Cancer Center.

"However, some treatments that keep cancer cells at bay can cause serious side effects. The side effects can increase the risk of secondary cancers by suppressing the patient’s immune system or destroying normal bone marrow cells. We're trying to get away from a blanket approach where we're destroying normal cells along with the cancer cells."

She and her colleagues, therefore, focus on researching and offering patients new targeted therapies for lymphomas and myelomas. Some of the most promising of these treatments combine chemotherapy with targeted agents called monoclonal antibodies.

These new agents encourage the body’s immune system to target the cancer cells. This approach, Gregory says, kills more cancer cells than previous treatments while limiting lasting side effects by protecting patients’ normal cells.

Rethinking leukemias

At the The Coleman Foundation Comprehensive Leukemia Clinic, physicians have a similar focus on finding treatments that both fight cancer and improve patients' quality of life.

For example, Melissa Larson, MD, director of the clinic, is enrolling patients in a nationwide trial of a new chemotherapeutic pill to treat acute leukemias — with promising results. The medication, called sapacitabine, put one patient's leukemia into remission for 20 months, compared with a median survival of 6 months for his type of disease.

"The thought of being able to give patients a pill they can take at home, so they're not forced to have a long hospital stay, is amazing," Larson says, explaining that patients with acute leukemias often have to stay in the hospital for extended periods to receive regular infusions of chemotherapy. "This potentially will change the way that we're treating leukemias."

Streamlining treatments

By opening comprehensive clinics for patients with lymphomas, leukemias and myelomas, clinicians at Rush have already changed one important aspect of the way these conditions are treated.

Instead of being referred from one specialist to another, patients at these clinics meet during a single appointment with all the specialists involved in care, including hematologist/oncologists, bone marrow transplant specialists, pathologists, nurses and others.

The specialists discuss each case and collaboratively determine the best course of action for each individual patient. "You're going to see more and more of these kinds of clinics start to spring up," Gregory says. "It really gives the patient an advantage to have a whole group of experts evaluating their cancer and tailoring their care — especially when those experts are involved in developing the latest treatments."