Rising to the Challenge
Leukemia survivor credits clinical trial for milestone remission
Anne Holzbeierlein likes a challenge. She plays tennis, hikes, zip lines and enjoys white water rafting with friends and family.
In her 11 years as vice president of development at the University of Central Oklahoma and president of the UCO Foundation, in Edmond, she has taken on new challenges with the same fervor. So when an easy stroll across her home campus suddenly became exhausting in spring 2013, Anne visited the university health center for a blood test.
“I’ve always been very active and have rarely even needed to take a pill for anything. I knew I wasn’t myself,” she said.
Late that same evening, a physician called and advised her to go to the emergency department. There, she was diagnosed with acute myeloid leukemia (AML) at the age of 68.
Physicians at a local Oklahoma hospital began initial treatment for the leukemia, but Anne’s case was anything but typical. Molecular analysis of her blood showed her cancer to be the most aggressive form of leukemia. The next challenge: Anne would need a bone marrow transplant, but a full match could not be found among family members or on the national registry.
Anne’s son Jeffrey Holzbeierlein, MD, a urologist with The University of Kansas Cancer Center, encouraged her to meet with physicians at the cancer center to discuss advanced treatment options.
“She was at extremely high risk for relapse, with zero chance of her leukemia being cured by chemotherapy alone,” said Dr. Holzbeierlein. “With no donor match, our options were pretty limited. We realized the outcome may not be good, but this was the place to explore the options.”
Joseph McGuirk, DO, medical director of the cancer center’s blood and marrow transplant (BMT) program, said Anne’s timely referral was critical to her favorable outcome. Dr. McGuirk, who advised the Holzbeierleins along the way, said patients of all ages who are eligible for transplant need to proceed before their disease becomes unmanageable. Through Dr. McGuirk, who also is director of the Division of Hematologic Malignancies and Cellular Therapeutics, the Holzbeierleins learned about a clinical trial that had the potential to make a difference.
“Just 10 years ago, she would have been given zero chance of survival. Now, researchers are discovering how to use these alternative donors to truly change the course of these aggressive cancers. To see her so vibrant and healthy today makes you realize the magnitude of these discoveries.”
Joseph McGuirk, DO
Medical Director of the Blood and Marrow Transplant program
Looking for answers
The Phase III clinical trial, open to patients age 65 or older with hematologic (blood) cancers, was a perfect fit. Other than her leukemia, Anne was in good health, making her an ideal candidate for a BMT procedure.
“You have to be in pretty good shape to go through this type of treatment and recovery,” Dr. Holzbeierlein said.
Participants in the clinical trial are randomly selected to receive one of two types of transplant: one using umbilical cord blood from an unrelated donor or the other using haploidentical bone marrow (a genetic half match) from a relative.
Anne was selected to receive the bone marrow transplant. As her son, Dr. Holzbeierlein was a half match. Further testing verified his blood type, health and other variables were compatible for the transplant procedure.
Because Dr. Holzbeierlein worked on-site, he was able to undergo surgery to harvest his bone marrow one morning and head back to work the next day.
Anne’s surgery was followed by a lengthy recovery. Doctors cautioned her she would need to remain in Kansas City for 100 days – away from home, work and a deeply rooted support system.
“It was difficult,” she said. “The idea of being away from home and out of my element for such a long time was overwhelming.”
After a few weeks in the hospital, Anne stayed with her son and his wife. Having a physician around was motivating. Dr. Holzbeierlein encouraged his mother to walk, ride the exercise bike and push her own limits during the first weeks of recovery when her energy and resolve were at their lowest.
But it was her resolve that helped her pull ahead. During treatment, she managed to work 10-20 hours each week, making calls and sending email from her hospital bed in the first few days.
“I kept busy,” she noted. “I had my phone, my laptop and even a printer. For me, this made a huge difference, to be able to do the things that were part of my daily life. It was a great distraction.”
The power of research
In July, Anne celebrates an important milestone – two years in remission from her AML. Patient outcomes improve considerably at the two-year mark. In fact, 90 percent of patients who relapse do so within the first six to 12 months. Complications beyond two years are rare.
It is a milestone she credits to the power of research.
“I’ve always valued research and the idea of being part of something that can help people down the road,” she noted.
In Anne’s case, research added a compelling chapter to her story.
“Just 10 years ago, she would have been given zero chance of survival,” said Dr. McGuirk. “Now, researchers are discovering how to use these alternative donors to truly change the course of these aggressive cancers. To see her so vibrant and healthy today makes you realize the magnitude of these discoveries.”
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