A new and unique partnership between Hamilton Health Sciences (HHS)’ Juravinski Hospital and Cancer Centre (JHCC) and the Grand River Regional Cancer Centre (GRRCC) is keeping treatment close to home for certain blood cancer patients. The partnership makes it possible for patients in Kitchener, Waterloo and Wellington to receive an autologous stem cell transplant, which uses cells from their own body, at Kitchener’s Grand River Hospital instead of travelling to Hamilton for this highly specialized, intensive, multi-day
treatment.
This partnership is the first of its kind provincially, and could lead to other community hospitals with regional cancer programs offering stem cell transplants with support from large academic hospitals like HHS.

Training others in highly specialized and complex care

The JHCC is a leader in adult stem cell transplant and cellular therapy, and home to one of the largest and most comprehensive regional cancer programs in the province.
The JHCC’s cellular therapy and transplant team spent two years working with Grand River to train their team in providing autologous transplants, which are used to treat patients with multiple myeloma or lymphomas. With this type of transplant, healthy stem cells from the patient’s own body are used to help the body recover from high doses of chemotherapy.
As part of this process, healthy blood cells are removed and collected before high doses of chemotherapy are administered to kill cancerous cells. Healthy cells are then introduced back into the body through the transplant process to promote recovery.
“Providing today’s specialized and highly complex cancer treatments requires teamwork and collaboration of hospitals, physicians, clinical staff and patients,” says Dr. Kylie Lepic, medical director of JHCC’s cellular therapy and transplant program.
“Stem cell transplants require that collaboration to meet strict regulatory requirements and to ensure the safety and effectiveness of the treatment. We are pleased to see the autologous stem cell transplant program at Grand River launch successfully after so much preparation. It’s a true partnership.”
The GRRCC performed its first successful transplant in July, in partnership with the JHCC team, and with the support and endorsement of Cancer Care Ontario, an agency created by the province to connect and coordinate Ontario’s health care system.
“We’re happy to report that everything went to plan and that the patient is doing exceptionally well,” says Dr. Janet MacEachern, a hematologist-oncologist and medical director of transplantation and cellular therapy for GRRCC.
This procedure marks the completion of the first phase of the transplantation and cellular therapy program at GRRCC.

An increasing need

Grand River is the seventh hospital in Ontario to provide autologous transplants. The other six are large academic hospitals: Hamilton Health Sciences (at the JHCC), University Health Network in Toronto, Ottawa Hospital, London Health Sciences Centre, Kingston Health Sciences Centre, and Health Sciences North in Sudbury.
The benefits of expanding to community hospitals such as Grand River include patient convenience, since it’s common for Ontario residents needing a stem cell transplant to travel hundreds of kilometres for this procedure at a large centre.
Expanding to other hospitals would also help build provincial capacity since demand for autologous stem cell transplants is growing. That’s partly because people are living longer, so more and more Ontario residents are being diagnosed with multiple
myeloma or lymphomas.
Also, innovations in treatment mean that an increasing number of multiple myeloma or lymphoma patients are qualifying for transplants. Expansion would help meet the growing demand.

Learning through simulated transplants

The JHCC’s cellular therapy and transplant team provided training to GRRCC team members including hematologists, nurses, lab staff and quality managers for two years to help them build the specialized skills and treatment pathways needed to perform transplants.
The JHCC’s contributions also included site visits, logistical meetings, educational sessions, and simulated transplants. The JHCC team continues to be a resource for their GRRCC colleagues and partners with them in providing patient care.
While Kitchener-area patients still visit JHCC for consultation, the bulk of their treatment is carried out at GRRCC. For example, through this partnership, patients qualifying for a stem cell transplant meet with a JHCC transplant physician in Hamilton. This specialist creates their treatment plan, and their healthy cells are collected and processed in Hamilton. The collection process can take one to three days. The patient’s processed, healthy cells are couriered to Kitchener to await transplant.
The remainder of treatment happens in Kitchener, including intensive chemotherapy leading up to the transplant to kill diseased cells, as well as the transplant itself, and follow-up care.
“This is a monumental milestone for cancer care for Waterloo-Wellington and beyond,” says Jane Martin, the GRRCC’s vice president.
“The transplantation and cellular therapy program not only supports the overall provincial health care system, it also ensures that patients receive the care they require without the need to travel out of region.”

By Lise Diebel
Lise Diebel works in communications at HHS.