My partner who is 37 years old was diagnosed on 4/20/2012 with AML M4. We later found out that she is FLT3-ITDpos which took her "good" prognosis and changed it to "okay/poor". Due to the molecular abnormality our oncologist thinks that a BMT would be the best next step. She made it through induction chemo and a achieved complete remission. We live in Ohio and he is wanting to send us to the James Cancer Hospital at Ohio State University. He is wanting her back on some kind of treatment by next week be it chemo with him or at the James or starting BMT. We have a consultation at the James tomorrow but are not sure that is the best place to have a BMT. There never seems to be enough time to get our feet under us to we can make truly informed decision before being thrown into another treatment. Our doctor says that most BMT places are the same at this point and unless we just want to be somewhere "famous" the James is just fine. Any help, guidance or advice at this point would be greatly appreciated!!!
Hi. I just did a brief search. James is an NCI cancer center. I'd do a bit of research and look at how many transplants they have done and what the outcomes are. There's only one other NCI hospital in Ohio. It's up to you whether you want to travel - and whether your partner's insurance will pay. Basically, the more transplants a hospital does, the better it is for the patient, because not only are the MDs really experienced, but so are the nurses. Experienced nurses are the backbone of a transplant program. I adore my MD, but although the hospital is restarting a transplant program that went into abeyance (I'm not sure why), and they've lured someone who ran a program in another state, I wouldn't do my transplant there, because much as I LIKE the nurses on the oncology unit, they don't have (at least not yet) a dedicated transplant unit, and the nurses aren't accustomed to dealing with transplants on a daily basis. I'm fortunate to live in NYC, so I do have access to a major cancer center. Some centers are "famous" because they do a lot of research, but some are "famous" because of the pioneering work they have done - and because of their high percentage of good outcomes. Obviously, every case is different: patients come with different risk factors - be it co-morbidities, cytogenetic issues, age issues, etc. I know of someone who had been treated at one of the most famous cancer centers, but they refused to take her insurance for a transplant. I happen to know that she is a very high-risk patient, and I bet your bottom dollar that they just didn't want to take the risk. Fortunately for her, another equally famous center did.
The reason your partner's MD is so anxious for her to have continued treatment vs. going straight to transplant is because he fears her remission won't last - especially given her risk factors.
Keep writing in. I'd also now switch to posting on the AML discussion board. You might get more responses there.
BTW, I'm an AML patient and a PT who has worked at a major cancer center.