U-M Comprehensive Cancer Center - Update March 2014

U P DAT E M A R C H

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Bone Marrow Transplantation Program Expands The Adult Blood and Marrow Transplantation (BMT) Program at the University of Michigan Comprehensive Cancer Center is expanding our faculty in both clinical care and research to meet the demand for more patients needing this highly complex and specialized treatment.

In this issue we welcome Mary Riwes, D.O., to the transplantation faculty (see pg.2). Riwes adds another fulltime specialist to our program, which is already one of the largest in the Midwest. In addition, researcher Brian Parkin, M.D., began last year, focusing on integrated genomic characterization of refractory acute myelogenous leukemia (AML) to determine mechanisms of chemoresistance as well as the development of novel ultradeep sequencing methods for detecting minimal residual disease in AML patients before and after allogeneic stem cell transplantation.

Our transplant team treats more than 200 patients annually who require BMT for their condition, including: • leukemia • lymphoma • myelodysplasia • neuroblastoma • bone and soft-tissue sarcomas • brain tumors • other conditions including the failure of a patient’s own bone marrow or certain immunodeficiency disorders “Our team of nearly 100 physicians, nurses, midlevel practitioners and transplant coordinators are specially trained in and solely devoted to marrow and hematopoietic stem cell transplantation, so your patients can receive compassionate care, multidisciplinary collaboration and the latest research innovations,” says BMT program director Daniel Couriel, M.D.

Patients receive this level of care through every aspect of treatment, from the initial patient consult, to transplantation, to post transplantation care and transition back to everyday life, providing the ideal patient care experience.

Each patient is part of a team consisting of a physician, a mid-level provider and a nurse, all of whom are transplant subspecialists. The team remains constant throughout the delivery of care, which means that someone who knows the patient is available at any time.

Our inpatient and outpatient care are fully integrated in a new state of the art, tertiary care facility with HEPA filtration throughout the entire unit – not just in the rooms. All outpatient care is provided at one location and coordinated to eliminate the need for separate trips to meet with the care team and to receive infusion treatments.

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Daniel Couriel, M.D. Director, Adult BMT Clinical Program Professor, Hematology and Oncology

Steven Goldstein, M.D. Associate Professor, Hematology and Oncology

John Magenau, M.D. Clinical Assistant Professor, Hematology and Oncology

Brian Parkin, M.D. Assistant Professor, Hematology and Oncology

Attaphol Pawarode, M.D. Clinical Assistant Professor, Hematology and Oncology

Mary Riwes, D.O. Assistant Professor, Hematology and Oncology

M-LINE I 800-962-3555 I mcancer.org

New facult y

ubspecialty,

The U-M Comprehensive Cancer Center has added new faculty to enhance the subspecialty, multidisciplinary care offered throughout the center.

Craig Cole, M.D. Hematology Clinic Assistant Professor, Hematology/Oncology.

He completed his fellowship and residency here at the University of Michigan (Ann Arbor, MI). Dr. Cole is a graduate of the Ohio State University College of Medicine (Columbus, OH).

Huong (Marie) Nguyen, M.D. Hematology Clinic Assistant Professor, Hematology/Oncology.

She completed her fellowship at Stanford University School of Medicine (Stanford, CA) and her residency at University of Washington Medical Center (Seattle, WA).

Dr. Nguyen is a graduate of Stanford University School of Medicine (Stanford, CA).

Mary Riwes, D.O. Bone Marrow Transplant Program Assistant Professor, Hematology/Oncology.

She completed her fellowship at the University of Florida (Gainesville, FL) and her residency at Cleveland Clinic Hospital (Cleveland, OH).

Dr. Riwes is a graduate of New York College of Osteopathic Medicine (Old Westbury, NY).

Vaibhav Sahai, MBBS Gastroenterology Oncology Clinic Assistant Professor, Hematology/ Oncology. He completed his fellowship at Northwestern University (Evanston, IL) and his residency at University of Pittsburgh Medical Center – Mercy (Pittsburgh, PA).

Dr. Sahai is a graduate of Government Medical College (Amritsar, India).

If you would like an introduction to any of the U-M Comprehensive Cancer Center’s faculty, please contact Physician Liaison Laurie Powell at beckwith@med.umich.edu or call M-LINE at 800-962-3555.

M-LINE I 800-962-3555 I mcancer.org

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To address the needs of patients who develop graft-vs.-host disease (GVHD), we offer one of the largest extracorporeal photopheresis centers in the world, performing more than 1,000 procedures yearly.

We also have a chronic GVHD clinic that includes physiatry and neuropsychology as well as access to a group of GVHD subspecialists in ophthalmology, gynecology, pulmonology and cardiology.

Post-treatment care To reduce readmissions, each patient has a follow-up plan implemented at discharge from the BMT unit, which includes transitioning into our Ambulatory Treatment Center.

This special outpatient clinic, located on the same floor as the inpatient care, allows patients to remain with the same treatment team during the early post-transplant phase until they are ready to transition back to their primary physician. The unit also allows for the possibility of offering outpatient transplants.

Research Our clinical research, led by Pavan Reddy, M.D., is dedicated largely to finding new and improved strategies to prevent relapse and complications after BMT. We offer cutting edge research with a broad portfolio to cover many diseases and treatment types, often based on our clinical care, basic research, translational and clinical research collaborations.

We are active in ongoing phase 2 and phase 3 clinical studies in multiple

myeloma, AML and lymphoma.

These studies are for both transplant and non-transplant patients.

U-M faculty members are recognized nationally and internationally for their expertise in treating acute and chronic GVHD. For example, Reddy’s team recently showed that using the drug vorinostat plus standard medications after transplant resulted in only 22 percent of patients developing GVHD compared to 42 percent of patients who typically develop this condition with standard medications alone.

“Graft-vs.-host disease is the most serious complication from transplant that limits our ability to offer it more broadly. Current prevention strategies have remained mostly unchanged over the past 20 years. This study has us cautiously excited that there may be a potential new way to prevent this condition,” says lead study author Sung Choi, M.D. Also last year, Cancer Center hematologist Ivan Maillard, M.D., discovered that inhibiting a signaling pathway in some of the transplanted cells could prevent GVHD in mice without serious side effects and without substantially compromising the cancer-fighting ability of the transplanted cells.

To learn more about the University of Michigan Comprehensive Cancer Center’s BMT Program, to consult with one of the transplant faculty or to refer a patient, call M-LINE at 800-962-3555, or contact Cancer Center Physician Liaison, Laurie Powell at beckwith@med.umich.edu.

Closer Than You Think The University of Michigan Comprehensive Cancer Center’s services are not solely offered on the University of Michigan medical campus, but throughout Southeast Michigan and the entire state.

Services offered in the community include: infusion, outpatient surgery, radiation oncology and clinic visits. See where you can find a U-M Comprehensive Cancer Center service below:

Cancer Care Brighton Health Center Canton Health Center East Ann Arbor Livonia Center for Specialty Care 5 Livonia Health Center 6 Northville Health Center (Summer 2014) 1 2 3 4

Radiation Oncology Allegiance Health Alpena Cancer Center McLaren Greater Lansing Metro Health Village (Wyoming) 11 Providence Park Novi 12 Providence Cancer Center Southfield 13 VA Ann Arbor 7 8 9 10

To refer a patient to one of our community locations or to the Comprehensive Cancer Center, call M-LINE at 800-962-3555.

M-LINE I 800-962-3555 I mcancer.org

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If you would like to schedule an appointment, transfer a patient, or request a consult, please call

M-LINE 800-962-3555 Please let us know what you think of this publication or if you would rather receive it electronically. You can contact Physician Liaison Laurie Powell or email us at CancerCenter@med.umich.edu

M-LINE: Your 24/7 connection to U-M Cancer Center After Ryan Wilcox, M.D., Ph.D., sees a patient referred to him from outside the University of Michigan, he turns to M-LINE. The service representatives connect with the referring physician’s office and page Wilcox when the physician is available to talk.

“I prefer talking to real people, rather than mailing a letter that arrives two weeks after the patient’s appointment,” says Wilcox, assistant professor of hematology/oncology.

“MLINE makes it very easy and convenient to make that personal connection.”

Ryan Wilcox, M.D., Ph.D.

With M-LINE, you can reach any U-M Comprehensive Cancer Center doctor 24 hours a day. Each service representative has the knowledge and expertise to guide you where you

need to go and to what you need to know. Services include scheduling an appointment, coordinating a patient transfer, requesting a physician-tophysician consultation, getting a status update on a hospitalized patient or reviewing lab, test and procedure reports.

Wilcox used M-LINE nearly 100 times over the last year. From a patient’s point of view, he points out, this personal connection can be reassuring, enhancing the sense that he is partnering with referring physicians in managing each patient’s care.

Call M-LINE at 800-962-3555.

In addition, Laurie Powell is our physician liaison for oncology services.

Laurie is available to meet with you or your staff to understand better how we can partner with you in the care of cancer patients. Please contact Laurie at beckwith@med.umich.edu.

University of Michigan Comprehensive Cancer Center Max S. Wicha, M.D., Director; Marcy B. Waldinger, MHSA, Chief Administrative Officer Executive Officers of the University of Michigan Health System

The Regents of the University of Michigan

Ora Hirsch Pescovitz, M.D., Executive Vice President for Medical Affairs; James O. Woolliscroft, M.D., Dean, U-M Medical School; Douglas Strong, Chief Executive Officer, U-M Hospitals and Health Centers; Kathleen Potempa, Dean, School of Nursing.

Mark J. Bernstein, Julia Donovan Darlow, Laurence B. Deitch, Shauna Ryder Diggs, Denise Ilitch, Andrea Fischer Newman, Andrew C. Richner, Katherine E. White, Mary Sue Coleman (ex officio).

The University of Michigan, is a non-discriminatory affirmative action employer. © 2014 The Regents of the University of Michigan