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The Road to Recovery


Tom Cappadona (right) with
David Avigan, M.D.

When Tom Cappadona was diagnosed with lymphoma in 1999, he researched his condition and interviewed several world-renowned oncologists before deciding which path his care would take. Choosing David Avigan, M.D., director of BIDMC’s Hematologic Malignancy and Bone Marrow Transplantation Program, as his oncologist was easy. “I liked Dr. Avigan at the outset…I could tell that he was a very warm type of person,” Cappadona recalls. “You want to be treated by someone you’re going to be able to communicate with.”

Choosing a course of therapy was more difficult – especially when Avigan recommended an aggressive six-month course of chemotherapy, followed by a bone marrow transplant using blood stem cells from Cappadona’s sister. “I resisted the transplant from day one,” says Cappadona, who knew the risks and long recovery such a procedure entailed.

The chemotherapy put him into remission until December 1999, when his disease returned. Again Avigan suggested a stem cell transplant; again Cappadona researched his options, trying new treatments without success to avoid a transplant.

A two-hour meeting between doctor and patient convinced Cappadona that the procedure was his best option. “I had to face up to the fact that I was resistant to chemotherapy and would die if I didn’t fight in an aggressive fashion,” he says. “Dr. Avigan would never force you to do anything, but he would enlighten you as to what the facts were. He was very caring in his approach with me. He’s just that kind of person.”

Cappadona was admitted to BIDMC the following day, and received his stem cell transplant days later on March 23, 2000. “The care was outstanding…the nurses were fabulous,” he says. “I can’t speak highly enough about Dr. Avigan’s staff and the nursing staff on Four South.”
Cappadona was well enough to leave BIDMC in only 23 days. While Avigan had warned him that he might not be able to return to work for a year, just three weeks later Cappadona was back on the job part time at his real estate business, wearing a mask and gloves. Several months later, he resumed working full time, which he continues to this day. “Dr. Avigan was floored!” he laughs.

Today, two years post-transplant, Cappadona continues to see Avigan, but notes that they don’t have a lot to talk about because “I feel wonderful!” While he is glad that he went through with the transplant, he admits that it was a difficult experience – one that he is trying to make easier for others by serving as an advocate for patients contemplating stem cell transplants.

“It’s devastating to get that kind of news [about needing a transplant] and have to go on trying to live a normal life,” he says, but adds that with a positive attitude and good medical care, it is possible to have a happy, healthy future. “I walk a lot and do the treadmill. I’m in great shape, and I say, ‘Let’s keep going.’”

- Valerie Hope Goldstein


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Published monthly for the people of Beth Israel Deaconess Medical Center to build community, communicate direction, foster pride and recognize accomplishments.

Produced by Beth Israel Deaconess communications, (66)7-7300

director, internal communications:
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managing editor:
   Valerie Hope Goldstein
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   Jen McGrath
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contributing writers: Roanna Forman, Anna Kalluri, Lisa Linden, Lori Howley
contributing photographer: Bruce Wahl



© CareGroup, Inc., Boston, MA, USA, 2002. All rights reserved. Material may be reproduced only with the express written consent of communications.

 

 

 














Program Expands Options for
Patients with Cancer
Marilyn Bernstein, Ginny Thomes, Anita Homer
Above: Members of BIDMC’s Hematologic Malignancy and Bone Marrow Transplantation Program

BIDMC’s Hematologic Malignancy and Bone Marrow Transplantation Program has grown to become a leader in the rapidly changing field of bone marrow transplantation. The program has long been known for its successful use of autologous transplants, in which a patient’s stem cells are extracted from his or her blood and reinfused following high-dose chemotherapy to eliminate solid and hematologic malignancies. In recent years the program has significantly expanded to focus on care for patients with blood cancers such as leukemia, lymphoma and multiple myeloma through transplantation of bone marrow or stem cells from matched sibling or unrelated donors.

“Donor bone marrow transplantation is a highly successful form of immune therapy,” says David Avigan, M.D., who directs the program. “With each new advance, the program has been able to offer our treatments to individuals who otherwise might not have been candidates. Many advances have also helped ease the overall treatment process and reduce the risk of complications.”

Avigan’s fellow transplant team members include Robin Joyce, M.D., James Levine, M.D, David McDermott, M.D., and specially trained nurses, social workers, clinical research assistants and administrative staff. All cell processing is performed by BIDMC’s Stem Cell Laboratory under the direction of Lynne Uhl, M.D. The multidisciplinary team meets several times a week to review patient care issues, and works closely with other Harvard Medical School institutions and the Eastern Cooperative Oncology Group, one of the largest U.S. clinical cancer research organizations, to speed new treatments from bench to bedside.

One such advance is allogeneic peripheral blood stem cell transplantation, in which the patient receives a transplant from a matched donor with the same genetic “fingerprint,” allowing for faster recovery (see patient story, left). However, receiving a transplant from a parent or sibling is not an option for every patient. Earlier this year, following an extensive evaluation process, BIDMC was designated a transplant site for the National Marrow Donor Program (NMDP) and opened a matched unrelated donor transplantation program. The NMDP provides access to donors from around the world through a registry of more than four million donors.

The program also has begun offering “mini-transplants.” Traditional bone marrow transplantation eliminates a patient’s bone marrow through high doses of chemotherapy and radiation. By contrast, mini-transplants allow for treatment with much lower doses of therapy, using the donor’s immune system to fight the cancer. As a result, treatment and recovery are easier, making the procedure more feasible for some older patients.

BIDMC also has an active research program to develop novel approaches to transplantations and other immune-based therapy. Staff are studying antibodies that target lymphoma cells and are developing cancer vaccines that work by fusing disease-fighting cells with a patient’s tumor cells. Clinical vaccine trials are currently enrolling patients with multiple myeloma and kidney cancer. Says Avigan, “As we expand our knowledge in the fields of transplantation and immune therapy, we hope to more effectively treat patients with these complex diseases.”


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