Using world-class transplant services to radically improve a patient’s prospects
At the age of 42, Graham was diagnosed with Acute Myeloid Leukaemia.
Graham was a 42 year-old family man, who worked hard for a large organisation in the City of London. When not working, Graham liked to spend quality time with his wife and their two small boys.
Graham was careful to look after his body, and enjoyed keeping fit by jogging in the evenings and taking regular walks in the countryside. He also opted-in to his company’s health insurance plan, which Graham used to attend a GP practice. At one of his annual medicals, Graham’s full blood count was abnormal. That same afternoon, Graham was contacted by his GP who asked him to return for a repeat blood test. Within an hour of his second visit, Graham’s doctor confirmed that the repeated blood test was also abnormal.
The doctor explained that, as a consequence of the abnormal result, he wanted Graham to be seen by a consultant haematologist, a specialist in conditions of the blood and blood-forming tissues. Graham’s GP made contact with HCA’s specialist haematology unit: Harley Street at UCH. This unit runs a comprehensive haematology service, working with international specialists in haematology to deliver world-class patient experience and outcomes.
An appointment was made for Graham to see a haematologist that afternoon.
Haematology private treatment centre
Graham was deeply concerned about what the problem may be. Anticipating this, the team at HCA’s dedicated haematology private outpatient and day-care treatment centre ensured that Graham was met by a specialist nurse on his arrival, who escorted him to his appointment with the haematology professor. The professor explained that the abnormal blood count was representative of many potential conditions, varying in severity, but that it was important to investigate immediately. To aid diagnosis, Graham underwent a procedure to collect a sample of his bone marrow.
Bone marrow aspiration
The more he heard, the more concerned and anxious Graham felt. Given the potential conditions, he was desperate to find out what was causing the problem. Graham was relieved that the team was able to complete a bone marrow aspiration within 30 minutes of his appointment, which is not possible in many other units. The procedure was performed by the nurse practitioner, a dedicated clinical nurse who is very experienced in guiding patients through such procedures and minimising the stress involved.
Graham’s bone marrow aspirate was transported immediately to the laboratories for analysis. The preliminary results would be devastating news for Graham: he was diagnosed with Acute Myeloid Leukaemia (AML). The professor spent time explaining the diagnosis and treatment required to Graham and his wife. The shock of the diagnosis and the speed that was now required to treat the leukaemia felt overwhelming to Graham. Fortunately, the dedicated HCA team is skilled in supporting patients in such a position, and helped Graham to absorb all the information and make the decision to commence treatment that same day. Graham was admitted to HCA’s specialist inpatient unit at Harley Street at UCH, and supported by the dedicated specialist nursing teams there.
Graham required high-dose chemotherapy, which meant a minimum 4-week inpatient stay, allowing the clinical teams to manage the side-effects of his treatment. He would be unable to fight infections, but the specialist team was on-hand to ensure they could respond immediately with antibiotics and supportive treatment to keep Graham safe throughout his treatment.
Graham found the dramatic change to his life almost unbearable, but the supportive team, including specialist psychologists, physiotherapists and dieticians were always available for him and his family. Graham and his wife were especially concerned about the impact on their young children. Knowing this, the HCA network gave the family access to child psychology and play specialists from its paediatric hospitals, who worked with their two young boys and the family as a whole.
At the end of his first cycle of treatment, Graham’s bone marrow began to produce normal blood cells, and a further bone marrow aspirate confirmed that he was in remission. Graham was elated, but also nervous: he was able to return home for a week with his family, but, after such intensive treatment, leaving the safety of the hospital was a daunting prospect. Fortunately, HCA’s specialist team were available 24 hours a day on a dedicated phone number offering support and advice at any time, day or night.
To consolidate the effects of the first course of chemotherapy, Graham needed a further 3 cycles of treatment, which required spending 5 continuous months in the HCA unit. During his first inpatient stay, the sample from Graham’s bone marrow was further analysed to gain an understanding of the genetic abnormality that was causing his leukaemia. The results showed that Graham’s best chance of survival was to have a bone marrow transplant.
Harley Street at UCH is a partnership between HCA and the UCH NHS Foundation Trust. HCA and UCH have worked hard to gain the rigorous JACIE accreditation for bone marrow transplantation, and become recognised internationally as a centre of excellence. Graham decided that he wanted to have a bone marrow transplant (BMT), and so the specialist team of BMT coordinators began the process of searching for a suitable donor.
A suitable donor was found
Graham had two brothers, both of whom wanted to see if they could help their brother by being his donor. Therefore both brothers agreed to be tested for suitability by providing a simple blood sample. As is standard practice in top centres, a separate consultant and transplant coordinator liaised with Graham’s brothers to ensure their interests were also looked after. The blood samples were swiftly tested in the specialist laboratories on-site, and one of Graham’s brothers was identified as a suitable donor.
Graham’s brother was subsequently supported by the psychologists and clinical teams to ensure that his own wellbeing was a priority, and successfully donated his bone marrow with the support of the clinical nurse specialists at UCH. Graham then underwent the transplant operation, receiving his brother’s cells after 10 days of chemotherapy to prepare his own bone marrow. This stage was a success, but the treatment was far from over.
It was critical that Graham remained an inpatient, so that the clinical teams could manage the immunosuppression treatment that would allow his new bone marrow to produce healthy blood cells.
After nearly a year of intensive treatment, Graham finally went home with this family. Following his successful treatment, Graham revisited the transplant team in the dedicated haematology outpatient centre twice a week, also visiting the supportive care clinic, which included a physiotherapist, dietetic support, continued counselling and consultant-led symptom management. This additional support was vital to Graham and his family, and helped him successfully adjust to life beyond a bone marrow transplant.
Graham’s story illustrates how the HCA network enables rapid access to the very best treatment for patients with blood cancers. Accessing all the different treatments in an integrated network not only boosted Graham’s overall outcome, but also minimised the trauma experienced by him and his family.
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