Respect Life Month
Appleton woman lives better thanks to stem cells
Her own blood provides way to fight cancer in bones
By Joanne Flemming
Jeanette Hanson of Appleton regards stem cell therapy as a blessing.
Such therapies have been controversial lately because they use stem cells from embryos. However, the transplant Hanson received on Feb. 2 to fight her bone marrow cancer used stem cells from her own blood -- in other words, adult stem cells.
While the transplant will not cure her, her physician, Dr. Laurence Tempelis, an Affinity oncologist, said it will prolong her life.
"It will buy me time and extend my life," said Hanson, a member of St. Joseph in Appleton. She added that, as her cancer cell level drops, her comfort level will rise. Right now, she is on painkillers for back pain. Her cancer, multiple myeloma, can cause bone pain and fractures.
Hanson's cancer was first discovered in her neck and back after she developed a stiff neck while jet-skiing three years ago on the lake near her cottage.
"I went over one small wave, and I got a stiff neck from that," she said. "A week went by, and the stiff neck got worse and worse."
Finally, her daughter took her to the hospital. She had a fractured neck.
Medical personnel said was too young -- 55 at the time -- to have such a fracture from such a little bump. They ran more tests and her cancer was discovered.
It had already spread through her whole back. More x-rays showed that she also had spots on arm and leg bones.
Multiple myeloma is a rare kind of cancer that cannot be detected by blood tests. When Hanson's physicians need to know her cancer count -- the number of cancer cells -- it requires a bone biopsy. Hanson has one every six months.
After her diagnosis, she received chemotherapy for five months. When her cancer count dropped to 3%, doctors harvested her stem cells.
Dr. Tempelis explained that while researchers think embryonic stem cells have the potential to develop into any kind of tissue, adult stem cells -- called second generation stem cells by oncologists -- seem to have limitations. (For more on stem cells, see Page 4-6A.) The hematopoietic cells (blood stem cells) taken from Hanson were second generation cells. Until recently, these cells had been thought only capable of producing three kinds of blood cells -- white cells, red cells and platelets.
The oncologist noted that Hanson's own stem cells were preferable for use. Once a patient reaches age 55, he said, there is an increased risk that transplants from other donors will cause complications (a risk with any transplant from another donor). One such complication can be "graft versus host" disease in which the donated cells attack the recipient's healthy tissue.
In order to harvest Hanson's cells, she needed heavy doses of chemotherapy to halt her blood cell production, Dr. Tempelis said. Then she received daily growth factor shots to stimulate new stem cells.
"When the white count recovered, the stem cells started mobilizing out of the bone and into the peripheral blood," he said.
At that point, harvesting could be done. For this, Hanson went to Mayo Clinic in Rochester, Minn. A pheresis machine removed white cells, containing stem cells, from her blood. This procedure can take six to eight hours and may be done more than once. Hanson went twice.
Her stem cells were then frozen and she went on maintenance chemotherapy for almost a year. Then there was a five to six month break, until a bone marrow biopsy showed that her cancer count was back up to 60%.
It was time for her transplant.
The transplant was done, as an outpatient at Mayo Clinic, over a three day period. First, a massive dose of chemotherapy was used to kill her own bone marrow. Then two large ports were surgically placed in her chest. Finally, four large tubes of stem cells were injected through the chest ports.
Hanson remained in Rochester for three and a half weeks, living at a motel with a family member or friend. She went to the hospital daily for blood transfusions. These transfusions, mostly red cells and platelets, supported her system until her own blood count rose. A patient may also be given growth factor to stimulate white cell growth.
Hanson said she has done well since the transplant and her cancer count has dropped to 3%. She added that her doctors have said it will never be zero.
She is on penicillin for a year and will have another bone marrow biopsy in December.
Hanson called the transplant a blessing.
"I was scared," she said. "I know that God helped us through it. He had to be there to give me strength. I just kept thinking this is going to be okay; I'm going to be fine. I had a lot of discomfort, but I can't say I would be frightened to do it again."