Rainbow’s Blood and Marrow Transplantation Program

Pictured from left to right: Susan Wiersma, MD, Kenneth Cooke, MD, and Vicki Fisher, RN

Raising the standard of care is how Kenneth R. Cooke, MD, intends to focus the growth and development of the long-standing Pediatric Blood and Bone Marrow Transplantation (BMT) Program at Rainbow Babies & Children’s Hospital. His ultimate goal is simple – build the program into something that is “too good to be ignored.”

The Pediatric BMT Program facilitates the transplantation of hematopoietic stem cells as a treatment option for a variety of congenital and acquired disorders of children and young adults. The program is part of the 64-member, Pediatric Blood and Marrow Transplant Consortium (PBMTC), and is a Children’s Oncology Group (COG) designated transplant center. The program also functions jointly with the Ireland Cancer Center’s nationally recognized, Adult BMT Program.

At Rainbow, BMT patients are managed by an integrated team of specialized physicians, nurse practitioners, social workers and nurses. Inpatient care is delivered in a 6-bed BMT unit within a hepa-filtered unit designated for immuno-compromised patients, while outpatient care is provided at the ICC.

Dr. Cooke recently joined the faculty at Rainbow and UH Case Medical Center (UHCMC). He was recruited as the Leonard C. Hanna Professor and the Ohio Eminent Scholar for Stem Cell and Regenerative Medicine because of his expertise in stem cell transplantation and the two most frequent complications following this procedure – graft-versus-host disease (GVHD) and acute lung dysfunction.

John J. Letterio, MD, division chief of Pediatric Hematology/Oncology, said Dr. Cooke’s experience and international reputation in caring for pediatric and adult BMT recipients assures that patients are in the hands of a qualified, dedicated physician-scientist.

“The designation of Ohio Eminent Scholar speaks directly to Ken’s outstanding reputation in the field and strategically gives him responsibility for bridging academic and commercial efforts to bring cutting-edge therapies into clinical practice,” Dr. Letterio said.

As director, Dr. Cooke has oversight of the pediatric BMT program at Rainbow. He also is the director of the ICC’s multidisciplinary initiative on GVHD that will coordinate treatment and research into this serious disorder.

According to Dr. Letterio, a research mission centered on improving patient care sets Rainbow apart from other area children’s hospitals. Rainbow is part of the Case Western Reserve University campus that includes the National Cancer Institute designated Case Comprehensive Cancer Center and the National Center for Stem Cell and Regenerative Medicine.

Drawing on these resources allows the BMT program to utilize distinct types of stem cells including recently discovered, non-hematopoietic, multipotent, mesenchymal stem cells (MSCs). Investigators at UHCMC have a leading role in using MSCs in various areas of regenerative medicine, and Dr. Cooke is using these specialized stem cells in his laboratory and in early stage, clinical trials in an attempt to improve outcomes after BMT.

Dr. Cooke’s plans to develop the BMT program will involve several steps, many of which are underway:

• Build upon an existing multi-disciplinary approach to outstanding patient care;

• Integrate an experimental “backbone” into established clinical programs;

• Enhance the clinical experience base by partnering with the larger, well-established, adult BMT program at UHCMC;

• Recruit physician-scientists to move therapies from the bench to the bedside;

• Identify specific clinical niches based on existing areas of expertise at UHCMC;

• Strengthen regional collaborations to provide advanced BMT care to patients throughout Ohio who are in need and create secure venues to co-manage patients following BMT.

Currently, Rainbow’s BMT team combines years of patient care experience, and expertise in supportive care, transplant-related complications and survivorship, with direct links to national cooperative groups.

Taking care of BMT recipients is one of the most complicated yet rewarding areas of medicine. “BMT is not simply a procedure to offer patients” said Dr. Cooke, “rather it represents an ongoing approach to care. The procedure, itself, is rather straightforward, but the care in the days, weeks, months and years that follow absolutely requires outstanding hospital services and a dedicated, well-trained group of practitioners. Anything less would be putting our most vulnerable pediatric patients at risk.”

Kenneth R. Cooke, MD, has developed several protocols for the treatment of acute GVHD and lung injury after BMT, two of which are currently open as part of national, multi-center clinical trials. He is also recognized as a Clinical Scholar of the Leukemia and Lymphoma Society and is the recipient of a Clinical Scientist Award in Translational Research from the Burroughs Wellcome Fund.

Susan R. Wiersma, MD, serves the COG as principle investigator at Rainbow and oversees the Rainbow’s BMT program.

Jeffery J. Auletta, MD, is board-certified in both pediatric oncology and infectious diseases and is an expert in infections occurring in immuno-compromised patients. His research interests are in immune reconstitution after BMT and establishing human MSCs as novel agents for the treatment and prevention of GVHD.

Vicki L. Fisher, RN, MSN, CPNP, has over a decade of experience caring for pediatric BMT recipients. She is recognized nationally as a leader in BMT nursing-related issues; she is the chair of the nursing section of the PBMTC and is the lead nurse for the BMT supportive care group for COG.

For information on Rainbow’s Blood & Marrow Transplantation Program, call (216) 368-1481 or go to www.rainbowbabies.org.

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