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oncology My Stem Cell Transplant A patient of the medical center's stem cell transplant program talks about how an innovative procedure saved his life TRACY "BEN" MILLER IS ONE OF THE MORE THAN 500 PATIENTS with blood and bone marrow cancers who have been treated by the bone marrow and blood stem cell transplant program at the University of Illinois Medical Center since its founding in 1997. Miller suffered from myelofibro- sis, a rare cancer of the bone marrow that reduces production of blood cells, causes a large increase in the size of the spleen and over the years leads to acute leukemia. As opposed to other bone marrow cancers, there is no chemotherapy that can cure myelofibro- sis, and a stem cell transplant is the only hope. Stem cell transplants from bone marrow or peripheral blood are difficult because the set of possible donors is much smaller than for organ transplants, and even siblings have only a 25 percent chance for a match. There is also a high risk of complications from a possible reaction of the donor's immune system in the stem cells against the recipient, called graft- versus-host disease. Fifteen years ago, Miller would not have even been considered as a candidate for this procedure: Patients over age 50 could not handle the level of chemotherapy required to prepare the body for the transplant. However, today's strategy in these cases allows for a reduced dose of chemotherapy to limit possible toxicity to the patient's organs but still be effective to attack the cancer. The University of Illinois Medical Center was the first hospital to use this limited-dose transplant procedure for myelofibrosis. Led by Damiano Rondelli, MD, director of the stem cell transplant program at the hospital, the program continues to be a leader in research on expanding the possibilities for stem cell transplants. After his procedure, Miller spent nearly a year recovering at his home in Sandwich before returning to work. Today, he is still taking im- munosuppressive medication, but eventually will be able to cease taking all medication from the procedure. Here, Miller shares his transplant experience, and what it means to be on the other side. M 28 | SPRING 2 010 y story begins in January 2005, when I went to the local hospital for some minor surgery. During the procedure, the doctor discovered that I had a disorder of the red blood cells. After two bone mar- row biopsies, my doctor was unable to diagnose my problem, and I was referred to the oncology clinic at the University of Illinois Medical Center in Chicago. After several more bone marrow biopsies and tests in Chicago, I was diagnosed with myelofibrosis. My blood count was closely moni- tored for over a year, with many trips from my home to downtown Chi- cago. In December of 2006, Dr. Ronald Hoffman observed that my white cell count had climbed to an alarming level. He asked me if anyone had discussed a stem cell transplant. All I can remember is how numb I felt knowing that the inevitable was near. My only knowledge of a stem cell transplant was that it was not fun and I was going to be very sick! The next four months were very busy with a variety of tests and consultations with Dr. Damiano Rondelli. I think that every part of my body inside and out was tested to ensure that I was healthy enough to go through a transplant, including detailed exams of my respiratory system and heart. Meanwhile the stem cell transplant team began the task of search- ing for a suitable donor after my sister was determined not to be a suit- able match. Fortunately about six donors in the National Marrow Donor Program were found to be near perfect matches, and a 19-year-old man was selected to be my donor. My family and I felt a great deal of relief once a donor was found, because we had heard it often isn't that easy. The big day arrived: May 2, 2007. I was admitted to the hospital and the process began. During the first five days I received eight chemo treatments, and two days later I received my new donor stem cells. One of the doctors and a nurse stood by as every last stem cell transferred through the IV and into my body. A day or two later "the hammer