The long road to day zero and beyond
There are some questions that even great doctors can't
answer. That's why pediatric hematologist/oncologist Morris Kletzel, MD, director of Children's Memorial Center for Cancer and Blood Diseases and Stem Cell Transplant programs, is both charmed and stumped
when a five-year-old boy with neuroblastoma
asks him, "Why did my cells start making bad cells?"
While the answer to this question may lie on the horizon of medical research,
a new regimen in stem cell transplantation developed by Dr. Kletzel and his team
at Children's Memorial is currently making some astounding gains in the survival
rates and outcomes of children with a variety of devastating diseases. The
clinical advancements are reducing the amount of time a child spends in the
hospital and are offering more comfort and less anxiety for patients and their
entire families.
A powerful treatment for deadly diseases
Each year approximately 200 children in Illinois receive
a stem cell transplant. It is an effective treatment for some of the most deadly
of all childhood diseases-cancers such as leukemia, Hodgkin's disease, lymphomas, neuroblastoma and solid tumors,
which account for 85 percent of the stem cell transplantations performed at
Children's Memorial. The remaining 15 percent of transplants consist of those
performed for disorders such as sickle cell anemia, thalassemia
, aplastic anemia and immune deficiency
disorders. Children's Memorial Hospital has become the region's leading
provider of care to children with neuroblastoma, a rare and aggressive form of
cancer that exclusively strikes children, most of whom are under six years
old.
A future of hope and potential
Dr. Kletzel leads one of the foremost pediatric programs
in the country. Children's Memorial performs more than 70 transplants a year and
was the first freestanding pediatric hospital to gain accreditation from
Foundation for the Accreditation of Cellular Therapy (FACT), a prominent oversight organization
in the field of stem cell transplantation. This accreditation is a hallmark of
excellence which focuses on program attributes including, program quality, excellence
of outcomes, a comprehensive and multi-disciplinary approach to care, research,
and quality stem cell processing/graft engineering laboratory services. Children's Memorial's program
includes a state-of-the-art laboratory capable of rapid DNA tissue typing
and donor matching, the ability to perform transplants on an outpatient basis and
innovative treatment protocols and procedures available only at Children's
Memorial. The program's multidisciplinary approach involves a core group of
caregivers consisting of physicians and advanced practice nurses, supported by
social workers, child life specialists, pharmacists and nutritionists devoted to
meeting the individual needs of each patient and family.
Day Zero
Among physicians, nurses, patients and families, the day a transplant is performed is universally known as "Day
Zero." The day actually represents a mid-point in the complex treatment regimen
that makes kids sicker before they get better. Prior to transplant, patients
receive high doses of chemotherapy and/or radiation — therapy that is designed
to eradicate the underlying disease and at the same time destroy the
immune system to make way for the new cells. After a transplant, patients cope
with a host of complications, including rejection and risk of infection while
they wait for their bodies to accept the new cells. It is a grueling process
that takes a tremendous physical, mental and emotional toll on the entire family
for months at a time. But, when successful, transplants give kids longer and
better quality lives—a hope that families find exhilarating. "Giving kids longer
and better lives is our goal," says Dr. Kletzel, "and it's one that we're
constantly working to improve."
For more information, please call 773.868.8046, fax 773.880.3019 or email mkletzel@northwestern.edu.