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The Hematology Program at Smilow Cancer Hospital offers the most comprehensive services for the diagnosis and treatment of blood cancers in the region. Our services are designed to meet each patient’s physical, emotional and psychological needs. Physicians within the program are organized into a multispecialty team that discusses the treatment plans for patients until consensus is reached on the best management course for each individual patient.
Physicians and scientists are still trying to grasp the causes behind myeloma, leukemia and lymphoma, the three major groups of blood cancers. But there is positive news: Advances in cancer care, some of which came from research at Yale Cancer Center, are increasing survival rates, leading to better blood cancer treatments and curing an increasing number of patients with these blood diseases.
At Smilow Cancer Hospital, we have an expert hematopathology diagnostic team capable of pathologic review of lymph nodes and bone marrow with in-depth molecular and cytogenetic analysis. Every diagnostic technique is available including: bone marrow examination, bone imaging, M protein analysis, cytogenetics, immunophenotyping, and FISH and PCR analysis. Diagnostic analysis also includes relevant genetic testing and the identification of markers of prognosis. Yale Cancer Center maintains a tissue bank used for novel research studies in blood cancer treatment and prevention.
Our physicians are finding particular success treating patients with various blood cancer types such as lymphoma, the most common blood cancer, now curing up to 80 percent of patients with Hodgkin's lymphoma. Dramatic advances have also been made in therapy for certain forms of leukemia, for example, with the development of molecularly targeted therapies such as Gleevec® for a leukemia termed chronic myeloid leukemia (CML). The outlook for patients with myeloma, another blood cancer, has also significantly improved over the last decade, with the introduction of new therapies such as thalidomide and bortezomib.
We have an expert hematopathology diagnostic team capable of pathologic review of lymph nodes and bone marrow with in-depth molecular and cytogenetic analysis. Every diagnostic technique is available including: bone marrow examination, bone imaging, M protein analysis, cytogenetics, immunophenotyping, and FISH and PCR analysis. Diagnostic analysis also includes relevant genetic testing and the identification of markers of prognosis. Yale Cancer Center maintains a tissue bank used for novel research studies in cancer treatment and prevention.
The overall aim of treatment is to bring about a complete remission. Treatment approaches for blood cancers may include chemotherapy, radiation oncology, stem cell or marrow transplantation, or immunotherapy. For maximum effectiveness, each patient receives an individual treatment plan, which includes standard care and/or clinical trials. Clinical Trials offering novel treatment options are available through Yale Cancer Center.
Patients at Smilow Cancer Hospital have the advantage of easy access to a disease-based multispecialty team with special interest and clinical expertise treating lymphoma, leukemia and myeloma. Physicians in medical oncology, hematology and radiation oncology meet regularly to discuss patient care and to develop a comprehensive treatment plan unique for each patient.
Patients and referring physicians can be assured of continuity of care. Referring physicians receive a summary of the transplant procedure and most patients return to their physician within two months of a stem cell transplant. Local referring physicians are welcome to and often participate in the Lymphoma Tumor Board to discuss the history and care of their patient with Yale Medicine physicians. Coordination continues with home care and supportive oncology, both integral parts of the treatment plan. Smilow Cancer Hospital has an extensive second opinion practice and collaborates with out-of-area physicians to coordinate patient care locally.
Additionally, patients have access to caregivers who help them cope with the physical, emotional and psychological issues related to these cancers. Advanced Practice Nurses and Social Workers assist with education, general information and practical issues of travel and accommodation assistance.
There are a variety of lymphoma treatment options available for cutaneous T and B-cell lymphoma and many patients are able to live relatively normal lives during and following therapy. Early diagnosis, cutting-edge lymphoma treatment, and novel therapies provide a significant benefit to patients with cutaneous lymphomas at Yale Cancer Center and throughout the world.
Yale Cancer Center continues to make innovative advances in the diagnosis and treatment of cutaneous lymphoma through the focused efforts of a ground-breaking clinical research team. Their multispecialty approach to the treatment of patients with cutaneous lymphomas has led to the development of FDA approved lymphoma treatments that are now the standard of care worldwide
Smilow Cancer Hospital offers a comprehensive program to meet the needs of patients with sickle cell anemia, also known as sickle cell disease. This program provides comprehensive services to meet the needs of patients and families living in the Greater New Haven area. The Sickle Cell Program's objectives are to educate the community, patients, families and health care providers about sickle cell disease, and reduce the number of hospitalizations and emergency room visits. The program offers high-risk adults the opportunity to be seen in the hematology clinic.
Several Smilow physicians are also experts in stem cell transplantation, which is part of standard blood cancer therapy for selected patients with myeloma, leukemia and lymphoma. Smilow is one of a handful of cancer hospitals in the country to perform haploidentical transplants, which allow patients to be transplanted with mismatched or half-matched donor stem cells from a family member with whom they have only one set of genes in common.
Yale New Haven Hospital is a member of the National Marrow Donor Program and is accredited as a major transplant center by the Foundation for the Accreditation of Cellular Therapy transplant accreditation committee.
In an effort to destroy abnormal cancerous cells in leukemia, lymphoma and multiple myeloma, stem cell transplants are often used. Together with Yale Cancer Center, we are the only center in Connecticut offering allogeneic transplant, a transplant using compatible donor stem cells. The number of allogeneic transplants performed annually at Smilow Cancer Hospital has doubled in the last four years.
Smilow Cancer Hospital also performs autologous stem cell transplant, which are stem cells removed from your blood by apheresis and are given back intravenously, and allogeneic stem cell transplant, which are stem cells received from another person.
T Cell Lymphomas have a number of different subtypes. The hematology team at Smilow Cancer Hospital has expertise in profiling patient’s tumors to determine the specific genetic mutations so treatment can be tailored. Novel monoclonal antibodies, targeted therapies, and inhibitors are all in study through clinical trials providing multiple options to patients. The role of stem cell transplants, both in newly diagnosed and relapsed patients, is also a treatment consideration that the team discusses at Tumor Board based on stage, health, and donor availability.
Myelodysplastic Syndromes (MDS) are a group of diverse bone marrow disorders in which the bone marrow does not produce enough healthy blood cells. A diagnosis is usually made using a bone marrow biopsy and there are typically not any early signs or symptoms. At Smilow Cancer Hospital, there are different treatment options available to patients, including clinical trials. Patients are treated based on their individual clinical and genetic features and classified as either lower risk or higher risk. Certain patients can be cured with aggressive treatment with chemotherapy followed by stem cell transplant using stem cells from a donor.
Classical hematology, or “benign” hematology, is non-cancer related blood disorders. Our hematologists provide a full spectrum of care to patients with non-malignant hematology disorders, and participate in research to advance treatment options for their patients.
The types of disorders that we care for are varied and include thrombosis, anemia, bleeding and platelet disorders.
Our patients benefit from specialized resources such as the state-of-the-art nuclear imaging technology, one of the largest total skin electron beam radiation oncology program worldwide, 3D conformal radiotherapy, intensity modulated radiation therapy (IMRT) and Gamma Knife services
Smilow Cancer Hospital at Yale New Haven offers cancer support groups.
When Marc St. Martin was diagnosed with cutaneous T-cell lymphoma (CTCL) in 2007, he had no way of knowing the impact it would have throughout his family. Over the course of five years, Marc underwent treatment with spot radiation therapy, total skin electron beam therapy, and chemotherapy, all in the hopes of achieving a durable remission.