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News from the University of Arkansas for Medical Sciences
UAMS
to Create Myeloma Institute
AUG. 22, 2001 | Chancellor I. Dodd
Wilson, M.D., announced this morning that the University of Arkansas
for Medical Sciences (UAMS) will create the world’s first Myeloma
Institute for Research and Therapy.
The institute will be dedicated exclusively to multiple myeloma and
focused on innovative treatment and research for this complex disease.
The new institute is a natural expansion of UAMS’s existing myeloma
program in the Arkansas Cancer
Research Center (ACRC). The UAMS program already is the
world’s largest for diagnosis and treatment for multiple myeloma, a
rare form of cancer in blood cells of the bone marrow. The disease is
extremely complex, affects multiple systems in the body, and often
evades diagnosis in its early stages.
While multiple myeloma often resists conventional therapy,
advances in basic science research have paved the way for prolonged
remission and curative therapies.
Bart Barlogie, M.D., Ph.D., founder of the Myeloma
Transplantation and Research Center (MTRC) in the ACRC and
former director of the ACRC, will lead the program.
 Meanwhile,
James Suen, M.D., will become the third director of ACRC. Dr.
Suen was one of the founders of the ACRC in 1984 and is chair of the Department
of Otolaryngology (Head and Neck Surgery) in the UAMS College of
Medicine. The previous ACRC directors were Kent Westbrook, M.D.,
(1989-98) and Bart Barlogie, M.D., Ph.D. (1998-2001).
“Expanding
the existing MTRC into a mature institute is a natural step forward in
the evolutionary growth of the cancer research program at UAMS,”
said Jerry Atchley, president of the ACRC Foundation Fund Board.
“Dr. Barlogie has been an outstanding clinician and researcher. His
work has profoundly and positively changed the lives of many patients
and their families, and he is literally a lifesaver to people around
the world. All of us at ACRC are excited about this plan.”
The founding president of the ACRC Foundation Fund Board, Betsy Blass,
commented, “The ACRC has cared for Arkansans and others who seek its
help in their fighting against many forms of cancer since it was
established in 1989 as the first center of excellence at UAMS. Our
supporters, including such philanthropists as Pat and Willard Walker
in Arkansas, private foundations, as well as the Arkansas General
Assembly, have made it possible for us to provide excellent medical
education in oncology, cancer research, and outstanding clinical
care.”
Frank Oldham, an ACRC patient, said, “Dr. Barlogie and his staff
saved my life. What a
tremendous blessing it is to receive the best treatment in the world
without having to leave my home state. The myeloma program at UAMS is
a bright, shining star in Arkansas and the world.”
Chancellor
Wilson commended Dr. Suen, the new director of ACRC: “Dr.
Suen helped to shape the founding vision of the ACRC as the first
Center of Excellence at UAMS, and he will carry it forward,” he
said. “He is a respected surgeon with a specialization in head and
neck cancer, an author and editor of medical school textbooks in this
field, a gifted teacher and mentor, and an able administrator. I’m
delighted that he has accepted this leadership post.”
A native Arkansan, Dr. Suen was born and raised in Dermott.
His undergraduate studies were performed at the University of Texas at
Austin. He attended the College of Medicine at the University of
Arkansas for Medical Sciences (UAMS), and entered an internship at San
Francisco General Hospital in California.
The
Myeloma Program at UAMS, 1989-2001
Purposes of the Myeloma Institute for Research and
Therapy
About the Arkansas Cancer Research Center
About Bart Barologie, M.D.
About James Suen, M.D.
About UAMS
About Chemotherapy
The
Myeloma Program at UAMS, 1989-2001
Bart Barlogie, M.D., Ph.D.,
introduced the myeloma program at the Arkansas Cancer Research Center
(ACRC) upon his arrival at the University of Arkansas for Medical
Sciences (UAMS) in 1989. It is based on his pioneering work in DNA
flow cytometery and the identification of factors contributing to
multiple myeloma. His research team has developed innovative and
comprehensive approaches to treatment of patients with multiple
myeloma and other hematological malignancies. Under his direction, the
Myeloma Transplant Research Center (MTRC) conducted
the first gene therapy for multiple myeloma in the U.S.
The program has since grown to world-class status under his
evolving leadership as director of the Division of
Hematology/Oncology, director of research at ACRC, and founding
director of the MTRC within the ACRC.
In 1998, he was also named Director of the ACRC.
The MTRC is one of ACRC’s 20 specialty clinics and medical services,
and it now enjoys an international reputation for diagnosis and
treatment of this form of cancer and for research excellence. Dr.
Barlogie’s treatment techniques earned the prestigious Jan
Waldenstrom Award in 1999. He
was recently (April, 2001) featured in an episode of the PBS science
series, NOVA, entitled “Cancer Warrior.”
The current director of the MTRC,
Guido Tricot, M.D., Ph.D., joined the team in 2000.
He was formerly a member of the medical staff at ACRC from
1993-97 as director of experimental therapeutics within the multiple
myeloma program.
The institute will extend the efforts of the MTRC, challenge
the disappointing results of standard chemotherapy treatment for
multiple myeloma, and explore better drugs and therapies for patients
through rigorously monitored clinical trials.
The center has previously achieved international recognition
for significant improvements in patient outcomes, and Barlogie expects
this to become even greater in the future.
The past success of MTRC has attracted government funding for
support of its continuing efforts along this promising line of cancer
research.
Purpose
of the Myeloma Institute for Research and Therapy
The Myeloma Institute for Research and Therapy at the
University of Arkansas for Medical Sciences (UAMS) “will provide
advanced medical training for oncologists with a specialization in
multiple myeloma, conduct pioneering research in this field, and offer
state-of-the-art treatment for patients from around the world,”
Chancellor Wilson said. Because the institute arises from the
world-class ACRC, “it will become the internationally recognized
center for this particular form of cancer.”
The Myeloma Institute will continue its pioneering research that has included the
discovery of thalidomide as an effective treatment, combination
chemotherapy, bone marrow and peripheral blood stem cell transplant
and tandem transplants with increased remission rates.
Bart Barlogie, M.D., Ph.D., director of the institute, envisions
satellite-based intensive training programs that will reach physicians
worldwide so that patients treated at the institute will have access
to specialized medical care upon returning to their home states or
countries.
“We have begun a campaign to raise funds for a new facility with
specialized clinical space and high-tech laboratories,” he said.
UAMS plans to construct the building atop the existing parking deck at
Elm Street and Capital Avenue as a home for the institute.The parking
deck foundation was initially planned and pre-stressed to allow for
vertical expansion, so the “footprint” of building is already in
place.
The new institute will continue the course already established by the MTRC
of comprehensive research and clinical care designed to further
develop curative therapies. The institute will provide world-class
patient care, conduct cutting edge basic science research, translate
laboratory research into clinical trials for advanced treatment, and
present specialized training for current and future specialists.
“Once complete,” Dr. Barlogie said, “the institute will be the
only one of its kind in the world dedicated exclusively to this
disease.” Initial staffing will include clinical faculty, basic
science research faculty, and an administrative team and support
staff.
The institute staff will design a strategic plan, work with
organizations to ensure financial support, develop informational
materials for increased public awareness, and build a national
consensus on the need for a focused response to multiple myeloma
research.
About the Arkansas Cancer Research Center
Founded
in 1984, the Arkansas Cancer Research Center (ACRC), one of the
centers of excellence at the University of Arkansas for Medical
Sciences (UAMS), is the only academic cancer center in the state. Its
specialty clinics and medical services are active in cancer patient
care, many of which are internationally recognized for treatment and
research excellence. The mission of the ACRC includes four major
functions:
To
provide compassionate, state-of-the-art care for cancer patients
The
ACRC is on the UAMS campus in an 11-story structure named the Pat and
Willard Walker Tower in recognition of the major benefactors. This
building contains laboratory and clinic space for 15 specialty clinics
and five research programs, 55 laboratories, a patient education
center, and patient support services.
Total outpatient visits at the cancer center have almost doubled since
1994, from approximately 40,000 in FY 1994-95 to more than 73,639 in
FY 1999-2000. New patient
visits have increased from approximately 4,200 in FY 1994-95 to 6,164
in FY1999-2000.
Patients come to ACRC from each of the 75 counties in Arkansas, from
every state of the union, and from countries around the world,
including England, Germany, Turkey, and Saudi Arabia.
Separate from but related to and supportive of the cancer treatment
provided at the ACRC is the new Central Arkansas Radiation Therapy
Institute (CARTI) facility located on the UAMS campus. UAMS radiation
oncologists and radiation physicists at the CARTI branch on campus are
members of a multidisciplinary team that combines medical and surgical
skills with radiation therapy, chemotherapy, and psychological and
spiritual support.
To
conduct landmark basic and clinical research
ACRC
includes almost 100 basic and clinical scientists having direct cost
funding exceeding $7.5 million for the period July 1, 1999 through
June 30, 2000. More than $6.6 million of this total was provided by national
agencies, such as the National Institutes of Health and the American
Cancer Society.
The myeloma research team led by Bart Barlogie, M.D., Ph.D., director
of the ACRC, recently pioneered the use of thalidomide in treating
myeloma patients. This is
the first new agent in over 30 years to have major anti-myeloma
activity. In 1999, the National Cancer Institute awarded Dr. Barlogie a
program project research grant of more than $13 million over the next
five years.
More than 1,000 patients participated in clinical trials at the ACRC
in 1999, the largest number in the history of the center. This means
that patients suffering from cancers of the brain, breast, colon,
skin, lung, prostate, and other sites received access to new drugs and
interventions before these therapies were widely available elsewhere.
To
provide excellent oncology training for health care students and
established professionals
More than 200 physicians attended weekend symposiums at the cancer
center during 1999 to learn about the latest advances in the
prevention, diagnosis, and treatment of colorectal, lung, and
hematologic malignancies, including multiple myeloma.
More than 150 professional and undergraduate students have
participated in the Partners in Research since its inception in 1975. Funded by the National Cancer Institute, this summer program
provides opportunities for students to participate in ongoing cancer
research and education activities in Arkansas.
To
inform the public about cancer and support cancer patients and their
families during treatment through counseling, support groups, and
education
The Witness Project, an
education program about breast and cervical cancer, reaches over 1500
African-American women a year in Arkansas. Seventeen states have now
replicated this program through funds provided by the Centers for
Disease Control and Prevention (CDC). The Ottenheimer Cancer Education
Center on the 10th floor of ACRC recorded more than 8,500 visits from
individuals seeking the latest information about cancer in 1999. The
Office of Clinical Oncology Social Work hosts five support groups each
month for patients and their families.
About Bart
Barlogie, M.D., Ph.D.
Bart
Barlogie, M.D., Ph.D., was educated in Germany and earned his medical
degree from Heidelberg University. Following residency training at the
Universities of Munich and Muenster, he joined the University of Texas
M.D. Anderson Hospital and Tumor Research Institute in 1974 where he
worked under Emil J. Freireich and colleagues in Developmental
Therapeutics. Eventually, he served as chairman of the Department of
Hematology.
In 1989, he accepted the position of director of Hematology/Oncology
and Director of Research at the Arkansas Cancer Research Center (ACRC)
at the University of Arkansas for Medical Sciences (UAMS). In recognition of his institutional leadership role in
myeloma, he was named the first director of a newly established
Myeloma and Transplantation Research Center (MTRC) and, later that
year, he also became the director of the ACRC.
Dr. Barlogie’s investigational career started with studies of tumor
cell kinetics in acute leukemia and turned to laboratory and
therapeutic investigations of multiple myeloma in the early 1980s. The
major milestones of his accomplishments are summarized below.
- He
developed the first effective salvage regimen for
melphalan-prednisone refractory myeloma (VAD regimen).
- The
next step was the development of initially bone marrow and
subsequently peripheral blood stem cell-supported high dose
melphalan regimens to overcome resistance to both standard
melphalan-prednisone and VAD, enhancing the incidence of complete
remission from less than 5 percent into the 50 percent range with
the use of tandem transplants as the primary management of newly
diagnosed patients. He and his colleagues also pioneered this dose
intensity approach in the setting of renal failure, a frequent
complication of multiple myeloma, as well as in the elderly,
recognizing that the median age of myeloma is 65 years.
- A
third fundamental contribution to myeloma therapy was the
demonstration of major activity of thalidomide in far-advanced
myeloma relapsing after tandem transplants.
As
a result of extensive laboratory correlative studies, Dr. Barlogie
also was the first to recognize a cytogenetically defined entity of
myeloma associated with a dismal prognosis despite dose-intensive
therapy (chromosome 13 deletion). Recent analyses of the first 1,000
patients treated at a single center recognized a substantial fraction
of patients who attained durable remissions beyond seven years
consistent with cure.
Thus the three major treatment principles established
by Barlogie and his colleagues include high-dose glucocorticoids,
stem-cell-supported high-dose melphalan, and thalidomide.
Dr. Barlogie’s pioneering work has stimulated confirmatory trials
worldwide. More so than any other myeloma investigator, Dr. Barlogie
challenged the conventional approach of disease palliation and
radically pursued the cure concept by treatment approaches aimed at
increasing the incidence of complete remission as a first critical
step toward that goal. In essence, he applied the lessons he was able to learn from
clinical trial investigations in acute leukemia to the myeloma
problem. The latest novelty is the post-transplant consolidation
strategy that has been shown to effectively delay disease recurrence
in high-risk myeloma.
These clinical investigations have been supplemented by extensive
laboratory research supported through R01 and program project grant
mechanisms from the National Cancer Institute, addressing the
fundamental issues of "Growth Control in Multiple Myeloma."
Dr. Barlogie’s work has been published in leading peer-reviewed
medical journals, and he recently received the prestigious Waldenstrom
Award for Myeloma Research.
Dr. Barlogie has published extensively including more than 270 peer
reviewed journal articles and 70 book chapters. His most recent works
include "Anti-tumor Activity of Thalidomide in Refractory
Multiple Myeloma" published in the New England Journal of
Medicine (November 1999); "Age is Not a Prognostic Variable
with Autotransplants for Multiple Myeloma" and "Total
Therapy with Tandem Transplants for Newly Diagnosed Multiple Myeloma"
both published in Blood (January 1999); "Anti-Myeloma
Activity of Pamidronate in vivo" published in the British
Journal of Hematology; "Superiority of Tandem Autologous
Transplantation Over Standard Therapy for Previously Untreated
Multiple Myeloma" published in Blood, "Advances in
Therapy of Multiple Myeloma: Lessons
from Acute Leukemia" published in Clinical Cancer Research,
and, in the fundamental research area, "Syndecan-1 is a
multifunctional regulator of myeloma pathobiology: Control of tumor
cell survival, growth and bone cell differentiation." published
in Blood. His research has also been published in Science,
Journal of Clinical Investigation, Journal of Clinical
Oncology and Cancer Research. Dr. Barlogie has served on
the editorial boards of Cell and Tissue Kinetics, Blood,
Clinical Cancer Research, Annals of Hematology, and International
Journal of Oncology.
The consequent pursuit of myeloma investigation at a single center
over the past 11 years has resulted in the world's largest clinical
referral center for multiple myeloma, thus enabling extensive
translational and novel therapeutic investigations building on an
unprecedented clinical and laboratory database.
Dr. Barlogie has been an engine of change in myeloma therapy for two
decades, as a result of which treatment principles have been
fundamentally changed, affecting superior clinical outcomes for patients
afflicted with this disease worldwide.
Dr. Barlogie is married to Kathleen Dandridge Barlogie, and they have
three children: Britta, Eva, and Bart.
About
James Suen, M.D.
James Y. Suen, M.D., is a
native Arkansan born in Dermott. His undergraduate studies were
performed at the University of Texas at Austin.
He attended the College of Medicine at the University of
Arkansas for Medical Sciences (UAMS), and entered an internship at San
Francisco General Hospital in California.
He served in the U.S. Air Force for two years before entering
residency in surgery and otolaryngology at UAMS. In 1973, he was an
Advanced Fellow in head and neck oncology at the M.D. Anderson Cancer
Center of the University of Texas at Houston. He returned to UAMS as
the chief of otolaryngology-head and neck surgery. He has been
chairman of the department for 26 years.
Dr. Suen has co-edited three editions of the medical textbook, Cancer
of the Head and Neck, with Eugene Myers, M.D., which is used
worldwide in medical colleges. He
has also published a textbook Emergencies in Otolaryngology,
and another book with Milton Waner, M.D., Hemangiomas and Vascular
Malformations of the Head and Neck.
His academic honors include: recipient of the Distinguished Alumni
Award from the University of Arkansas for Medical Sciences and from
the University of Texas M.D. Anderson Cancer Center. He received the
Distinguished Achievement in Medical Science by the Chinese Hospital
of San Francisco in 1998. He has been a guest professor at over 30
universities throughout the world and has published more than 110
scientific papers and book chapters. His main areas of interest have
been in head and neck cancer, otolaryngology, and vascular lesions of
the head and neck.
The Arkansas Cancer Research Center (ACRC) at UAMS, the shared vision
of Dr. Suen and Kent Westbrook, M.D., became a reality in 1989. Dr.
Suen has served as director of clinical services since the center
opened.
Dr. Suen is married to Karen Hannahs Suen and has four children:
Brent, Tiffany, Bradley and Brennan.
About UAMS
Based on its four-fold mission --
to teach, to search, to heal, to serve – the University of Arkansas
for Medical Sciences (UAMS) is the foundation of the modern health
care system in Arkansas. Dodd
Wilson, M.D., is the chancellor of the university – which is a part
of the University of Arkansas system. Dr. Wilson formerly served 14
years as dean of the UAMS College of Medicine.
Founded in 1879 by eight
physicians as the medical department of what is now the University of
Arkansas, it has become the major academic health-care center for the
state. Its educational programs for medical and health education
include the Colleges of Medicine, Pharmacy, Nursing, Health-related
Professions, and Public Health; plus the Graduate School.
UAMS Medical Center is also
located on the campus. It
is comprised of University Hospital and its many clinics. UAMS Medical
Center is now regarded as a world-class medical institution and was
included by U.S. News & World Report in its “Best
Hospitals in America” special edition for 2001 and in the previous
five annual editions.
The university operates four
centers of excellence that conduct teaching, research, clinical care,
and community service statewide in the fields of cancer, eye disease,
geriatrics, and spine and neuroscience.
These health-care milestones for
Arkansas were accomplished at UAMS: First open-heart surgery, first
bypass surgery, first bone marrow transplant, first kidney transplant,
first corneal transplant, first blood transfusion in the uterus, and
the first and only combined kidney/pancreas transplant.
About
Chemotherapy
Standard Chemotherapy
For more than 30 years, standard chemotherapy did not affect the cure
rate for patients with multiple myeloma. On average, patients
receiving the best available standard therapy (melphalan and
prednisone) lived only 36 months. The rate of complete but temporary
remission (no evidence of disease) was only five percent.
High-dose
Chemotherapy at MTRC
The approach of the Myeloma Transplantation and Research Center (MTRC)
to treatment with high-dose melphalan has increased the cure rate.
Patients also received by transfusion a single “bone marrow
transplant” of treated cells from their own body or from a matched
donor to help them recover from this aggressive chemotherapy protocol.
As a result, average life expectancy increased to 50 months and
complete remission rates increased significantly to 20 percent, a
four-fold increase. When patients also received a special type of cell
(mobilized peripheral blood stem cells) they recovered faster from
high-dose chemotherapy.
Total
Therapy I Protocol
From
1990 to 1995, Bart Barlogie, M.D., Ph.D., and his research group
further improved chemotherapy treatment to cause remission and
followed-up with two bone marrow transplants with high-dose melphalan.
Patients were then treated with interferon to keep them in remission.
With this approach, complete remission increased from the previous 20
percent range to almost 50 percent
– doubling the performance of previous efforts.
Total
Therapy II – the Newest Protocol
Ongoing
studies are now being conducted to discover how adding thalidomide, a
recently rediscovered powerful cancer-cell-killing drug, to the
chemotherapy mixture can further improve the rate and duration of
complete remissions in patients with multiple myeloma. Although the
drug is banned for use with women of childbearing age who may be or
want to become pregnant, the recent finding of its therapeutic value
for multiple myeloma patients is significant.
A recently published (June 2001) study showed dramatic results,
and clinical trials are continuing along this promising line of
research.
Photos
Top: Bart Barlogie, M.D.
Second: James Suen, M.D.
Links on This Page
Arkansas Cancer Research Center: http://www.acrc.uams.edu/
Myeloma Transplantation and Research Center: http://myeloma.uams.edu/
Department of Otolaryngology: http://www.otolaryngology.uams.edu/
© 2001 University of Arkansas for
Medical Sciences (UAMS). A single copy of these materials may be
reprinted for noncommercial personal use only. “UAMS,” “UAMS
Medical Center,” “UAMS Online,” “UAMS Today,” “uams.edu,”
and “Here’s to Your Health” are marks of UAMS.
08/24/01 |
