The Importance of Multidisciplinary Care in Bone Marrow Transplantation

Bone marrow transplantation at Sibley Memorial Hospital is an example of how crucial multidisciplinary efforts are in providing cancer care. Nina Wagner-Johnston, MD, said the operation requires involvement from the blood bank, the pathology department, the infectious diseases department, the cardiology department, and the emergency department.

Wagner-Johnston, a professor of Oncology and the director of Lymphoma Drug Development at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, director of Hematologic Malignancies National Capital Region, and co-director of Clinical Research for Hematologic Malignancies, also mentioned how, even with recent advances in treatments such as CAR T-cell therapies, physicians have had to work alongside departments like the palliative care team.

Now, palliative care professionals may be integrated into the treatment process earlier as it becomes clearer what subgroups of patients may not be able to achieve a cured state. As Wagner-Johnston said, “Their skill set is so important in dealing with these life-threatening illnesses.”

Transcript:

Activating the bone marrow transplant [program] at [Sibley Memorial Hospital], it was incredibly eye-opening in terms of just how many individuals touch a patient and how many programs need to be involved. Spanning from the blood bank to pathology, infectious diseases, cardiology, and the emergency department, activating the program at Sibley highlighted how multidisciplinary bone marrow transplant is.

Then, with regard to the multidisciplinary approach, and specifically with the question of palliative care, it’s been a really interesting era. With the availability of some of these novel therapies like CAR T, we have changed the course of illness in that many patients who are hospice-bound are now readdressing the potential for cure. Unfortunately, that cure does not apply to everyone, and there is going to be a subset of patients where we’re pivoting to say, “Okay, this didn’t work. Now, we need to think about what’s next, and focus on quality of life if we’re not successful in treating the cancer.” It’s become very challenging as we’re thinking about curative therapies that don’t work and when to pivot. Having the palliative care team involved at an earlier phase has become very important. Their skill set is so important in dealing with these life-threatening illnesses.