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Archive for March, 2017

Patient Shares Lung Cancer Journey

As a lifelong non-smoker, Susan Eldridge was shocked to learn she had lung cancer.

“I didn’t have any symptoms and thought I was pretty healthy,” says Eldridge. “But I started having some abdominal pain, and when they took a scan of my abdomen, they clipped part of my lung – which showed a tumor on the lower part of my left lung.”

The University of Nebraska at Omaha accounting professor turned to thoracic surgeon Rudy Lackner, MD, for help.

“She had early stage disease, so didn’t require any chemotherapy or radiation after the surgical procedure,” explains Dr. Lackner. “She was hugely lucky.”

Eldridge says Nebraska Medicine’s tagline of “Serious Medicine. Extraordinary Care.” really resonated with her.

“From the folks at the check-in desk, to the nurses and technicians – from top to bottom, everyone was so caring,” she says. “They know that patients are going to be anxious. Every single person helped me know that they were going to take care of me and that I was going to get the very best care. That’s the way it was. Today, I’m cancer-free and I owe that all to Nebraska Medicine.”

Learn more about Eldridge’s story.

 

Nizar Mamdani, Executive Director and founder of the International Healthcare Services at Nebraska Medicine says, “Dr. Rudy Lackner is an inspiring and remarkable example of the caliber of specialist and researchers working tirelessly to help provide better lung transplant treatment and educational opportunities.  Through collaborative strategic partnerships with 122 institutions in 44 countries, we continue to provide innovative educational and treatment options, as well as specialized tele-pathology and second opinion consultation services for Neurology, Cancer care and Transplantation patients around the world.”

Contact | nmamdani@nebraskamed.com; www.unmc.edu/international; +1 (402) 559-3656

 

Transplant Patient Celebrates Birthday with Special Visitors

 

Star Wars characters stormed the west atrium at the Durham Outpatient Center Feb. 10 to help Kylie Bush celebrate her birthday.

Star Wars characters stormed the west atrium at the Durham Outpatient Center Feb. 10 to help Kylie Bush celebrate her 11th birthday.

In December 2016, Kylie Bush had a small intestine, liver and pancreas transplant.

In December 2016, Kylie Bush had a small intestine, liver and pancreas transplant.

 

For years, Kylie Bush’s name was on the waiting list for a triple-organ transplant. At a young age, the Pineville, Louisiana, girl lost her small intestine and developed short gut syndrome. In December 2016, a match was found and the Bush family traveled to Nebraska for a small intestine, liver and pancreas transplant. Since then, she has continued to recover at the med center.

Feb. 10 marks Bush’s 11th birthday. To celebrate, Star Wars characters with The Central Garrison of the 501st Legion visited her and other pediatric patients at Nebraska Medicine. Bush’s 17-year-old sister is a Star Wars fan and helped arrange the surprise.

The festivities started by singing “Happy Birthday” to her, followed by presents and a fun photo opportunity. The visitors then met with other pediatric patients who are being treated for organ transplants, cancer and traumatic injuries.

The Central Garrison is an all-volunteer organization that dresses up in Star Wars costumes for charity and community events. The costuming club has about 100 members and covers Nebraska, Iowa, Minnesota, North Dakota and South Dakota.

Watch this brief video to learn more about Bush’s transplant journey.

The Stormtroopers were on watch during Kylie Bush's 11th birthday part Feb. 10.

The Storm troopers were on watch during Kylie Bush’s 11th birthday party Feb. 10.

 

Nizar Mamdani, Executive Director and founder of the International Healthcare Services at Nebraska Medicine says, “Our doctors are an inspiring and remarkable example of the caliber of specialist and researchers working tirelessly to help provide better transplant treatment and educational opportunities.  Through collaborative strategic partnerships with 122 institutions in 44 countries, we continue to provide innovative educational and treatment options, as well as specialized tele-pathology and second opinion consultation services for Neurology, Cancercare and Transplantation patients around the world.”

Contact | nmamdani@nebraskamed.com; www.unmc.edu/international; +1 (402) 559-3656

Emerging Therapies for Multiple Myeloma: ASH 2016 Update

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The ASH meeting emphasizes the critical importance of continued research efforts.

Although 2016 was a very exciting year for multiple myeloma, with the approval of four new drugs, the reality is that the majority of patients will become resistant to all available drugs. Therefore, it is still vitally important that new treatment strategies and new drugs are developed. At the recent annual meeting of the American Society of Hematology (ASH), there were many exciting presentations discussing new treatments. Here I will review some of the key studies exploring new treatments for relapsed/refractory myeloma.

CAR T cell therapy: CAR T cell therapy involves the engineering of one’s own T cells to be able to recognize a target on the cancer cell of interest in order to stimulate the patient’s immune system to attack the cancer cells. Investigators from University of Pennsylvania presented the results of CAR T cell therapy against BCMA in myeloma patients. Examples of patients who had very refractory disease prior to receiving this therapy were presented, several of whom had remarkable responses to the CAR T cell therapy. Not all patients responded to therapy and, as observed with other CAR T cell trials, the toxicities associated with this treatment can be very significant. There continues to be a lot of optimism about this type of therapy, although much more research is needed to determine the optimum target and ensure the safety of the treatment.

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Sarah Holstein, MD, PhD

Checkpoint inhibitor therapy: Checkpoint inhibitors, which harness the power of one’s immune system to fight cancer, are being widely tested in almost all cancers. These therapies have already been approved for the treatment of several cancers including bladder cancer, Hodgkin lymphoma, kidney cancer, lung cancer, and melanoma. As single agents, checkpoint inhibitors have not shown much activity against myeloma. However, ongoing studies are exploring the combination of checkpoint inhibitors with standard myeloma drugs. One study presented at ASH focused on the combination of the checkpoint inhibitor pembrolizumab with pomalidomide and dexamethasone. Around seventy percent of patients were refractory to both lenalidomide and proteasome inhibitors (bortezomib or carfilzomib). The overall response rate presented during the meeting was 65%. To put this in context, the expected response rate for pomalidomide and dexamethasone would be around 35%. This regimen is not without toxicity though, as 12% of patients suffered from pneumonitis (inflammation of the lungs) and 10% of patients discontinued therapy due to side effects.

Selinexor and penta-refractory disease: Selinexor is an oral drug which inhibits nuclear transport, thus this is a novel mechanism of action with respect to myeloma drugs. As noted above, although the new drugs approved for use in 2016 have improved outcomes for patients, most patients will become refractory to all available drugs. Penta-refractory disease refers to myeloma that no longer responds to lenalidomide, pomalidomide, bortezomib, carfilzomib, or anti-CD38 antibody (e.g., daratumumab) therapy. At that point, treatment options are limited. It was therefore interesting to see a new drug being tested in this patient population. This study investigated the combination of selinexor and dexamethasone in penta-refractory patients. Approximately 20% of these patients responded to this therapy. This therapy was associated with a number of side effects including nausea/vomiting, fatigue, diarrhea, and lowered blood counts. Thus although the majority of patients did not respond, there is evidence of activity and there are several ongoing studies investigating the use of this new drug in combination with other myeloma drugs.

Venetoclax: Venetoclax is an oral drug which works on a protein involved in regulating cell death (apoptosis). This drug is being tested in a variety of different hematological cancers, including myeloma. The results from a phase I study of the drug (either alone or in combination with dexamethasone), suggest that it may be particularly active in the subset of myeloma patients with t(11;14) (a translocation involving the #11 and #14 chromosomes in the myeloma cells). The overall response rate for the study was 21%, but was 40% in patients with t(11;14). In another study, venetoclax was tested in combination with bortezomib and dexamethasone. The overall response rate for the study was 68%. In this study, though, the response rates were similar regardless of whether patients had the t(11;14).

As always, the ASH meeting emphasizes the critical importance of continued research efforts. If new therapies are to be developed, then funding for the initial basic science research is required as is patient participation in the clinical trials. Without these, we won’t be able to offer new treatments to patients suffering from myeloma.

The information contained in this article is to be utilized for information purposes only. For specific questions regarding your medical condition or treatment plan please consult with your doctor directly. To schedule an appointment with a cancer specialist at Nebraska Medicine, call 800.922.0000.

Nizar Mamdani, Executive Director and founder of the International Healthcare Services at Nebraska Medicine says, “Dr. Sarah Holstein is an inspiring and remarkable example of the caliber of specialist and researchers working tirelessly to help provide better multiple myeloma treatment and educational opportunities.  Through collaborative strategic partnerships with 122 institutions in 44 countries, we continue to provide innovative educational and treatment options, as well as specialized tele-pathology and second opinion consultation services for Neurology, Cancercare and Transplantation patients around the world.”

Contact | nmamdani@nebraskamed.com; www.unmc.edu/international; +1 (402) 559-3656

Three Heart Transplants in 34 Hours

When transplant surgeon John Um, MD, walked into Nebraska Medicine – Nebraska Medical Center the morning of April 11, little did he know, it was the start of two very long days. By the evening of April 12, Dr. Um had performed three heart transplants in 34 hours – a personal best for himself and the transplant team at Nebraska Medicine.

“The surgeries were pretty long. About six to eight hours each,” describes Dr. Um.

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From left to right: Harvey Brandy, Lucas Kollars, Curt Spethman and Dr. John Um. It all started with 24-year-old Lucas Kollars of Arlington, Neb., who was found unresponsive at home by his mother. After receiving a left ventricular assist device (LVAD) and a right ventricular assist device (RVAD), Kollars was on the heart transplant waiting list for 58 hours.

“Dr. Um said I had about two more days to live,” says Kollars.

Twelve hours after finishing Kollars’ heart transplant, Dr. Um started on the second one. The patient was 57-year-old Harvey Brandy of Omaha. Brandy’s heart problems began several years ago with a heart attack. After receiving a stent and pacemaker, Brandy’s name was placed on the transplant waiting list. It took three days to find a match.

“At the time, I was feeling really, really bad,” says Brandy. “My heart was only functioning at ten percent.”

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While Dr. Um finished Brandy’s procedure, 60-year-old Curt Spethman of Omaha was being prepped for surgery. Spethman’s heart issues were fairly recent, but progressing quickly. His name was only on the transplant waiting list for five days.

“I was amazed at how fast it happened,” says Spethman. “You’re scared, but then you go – ‘I’m getting a heart. A second chance.'”

At 10:40 a.m. on April 12, Dr. Um began Spethman’s transplant. Even though it was his third in two days, Dr. Um was prepared and ready to go. He couldn’t let Spethman miss out on his second chance at life.

“I have a couch in my office where I can put my feet up, get some sleep and grab a coffee,” explains Dr. Um. “We also have multiple teams that are able to come in. They’re refreshed as well. This allowed everyone to be working at the best possible level. It’s a testament to the med center to invest in those resources and have the personnel to do those things.”

On May 11, all three patients met each other for the first time. They also thanked Dr. Um for his incredible work.

“I feel great. I’m walking around – about a mile or more a day,” says Kollars. “I want to thank Dr. Um and Dr. Aleem Siddique. They saved my life about nine different times.” “If it weren’t for the team at Nebraska Medicine, I wouldn’t be here. . It’s amazing what they do,” adds Spethman. “I’m now walking down the sidewalk and planting flowers again. It’s incredible.”

“One day, I’m going to come back and buy them a box of donuts,” laughs Brandy. “To show my appreciation.”

To learn more about the three heart transplants in 34 hours, watch this video.

 

Nizar Mamdani, Executive Director and founder of the International Healthcare Services at Nebraska Medicine says, “ John Um, MD is an inspiring and remarkable example of the caliber of specialist and researchers working tirelessly to help provide better heart treatment and educational opportunities.  Through collaborative strategic partnerships with 122 institutions in 44 countries, we continue to provide innovative educational and treatment options, as well as specialized tele-pathology and second opinion consultation services for Neurology, Cancer care and Transplantation patients around the world.”

Contact | nmamdani@nebraskamed.com; www.unmc.edu/international; +1 (402) 559-3656

Twin Diagnosed With Rare Form Of Cancer, Brother’s Stem Cells Save Life

By: Channing Barker

 

http://www.nwahomepage.com/news/fox-24/twin-diagnosed-with-rare-form-of-cancer-brothers-stem-cells-save-life/659566107

 

FAYETTEVILLE, AR. — – Bruce and Blair Johanson have been together since the moment of conception. They now work side by side in Fayetteville. They look, talk and even walk alike. They were told at birth they were fraternal twins.

“Whenever we would talk about being identical, mother would say no you’re fraternal and we’d say no we’re identical,” said Blair.

Something they doubted, especially in the past year when Bruce was diagnosed with Mantle Cell Lymphoma, a rare form of cancer.

“Once we learned with him what he was going to go through, praying that everything would work well with him and whatever we could do to support him through the process,” said Blair.

That included chemotherapy treatments and a trip to a specialist in Nebraska.

“At the very end, we were talking about family and I said ‘I have a twin brother ‘ and she says ‘What!?’ and she said ‘Well, that changes things,” said Bruce.

Doctors told Bruce, if he had an identical twin, there was a way his brother could be his true life saver.

“We need to have him tested to see if you’re truly identical and we want to use his stem cells versus your own, Since he’s cancer free,” said Bruce.

Blair gave new meaning to the term “brotherly love” and donated his stem cells.

“In my mind there was no question as to who the donor would be,” said Blair.

“It’s pretty special and awesome to have that,” said Bruce. “I mean,  we’re close as it is already, now we’re closer because I have his super cells.”

After dozens of treatments, Bruce was given the cancer free diagnosis last week.

“I wish everybody had a twin brother so they could get their stem cells from their twin brother or twin sister,” said Bruce.

The two are grateful for the doctors and the treatment made available by science.

 


Nizar Mamdani, Executive Director and founder of the International Healthcare Services at Nebraska Medicine says, “Dr. Julie Vose is an inspiring and remarkable example of the caliber of specialist and researchers working tirelessly to help provide better oncology treatment and educational opportunities.  Through collaborative strategic partnerships with 122 institutions in 44 countries, we continue to provide innovative educational and treatment options, as well as specialized tele-pathology and second opinion consultation services for Neurology, Cancer care and Transplantation patients around the world.”

 

Contact | nmamdani@nebraskamed.com; www.unmc.edu/international; +1 (402) 559-3656

 

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