Critical blood cancer treatment now available in Austin

Ryan Smith receiving the first allogeneic stem cell transplant at St. David's South Austin Medical Center
Ryan Smith receiving the first allogeneic stem cell transplant at St. David's South Austin Medical Center. (KXAN Photo)

AUSTIN (KXAN) — In the span of one month, Ryan Smith went from having a clean bill of health at a doctor’s appointment to feeling like he had the flu on a flight home. Another doctor’s appointment later, he learned he did have the flu — and cancer.

“No one ever anticipates, your husband gets home from a work trip and within a day you are facing an entirely new existence,” said Ryan’s wife, Jennifer.

Smith, a father of three, was diagnosed with an aggressive blood cancer, Philadelphia positive acute lymphoblastic leukemia. After the initial shock, they didn’t waste time figuring out how they were going to fight it. Smith started chemotherapy the very next day. “The process got moving so fast, there wasn’t time to sit back and mourn,” said Smith.

After chemo, Smith would need what’s called an allogeneic stem cell transplant, which up until then hadn’t been performed in Austin. With this procedure, a patient first undergoes total body irradiation to remove all stem cells from the bone marrow, so that healthy stem cells from a donor can be brought in.

Smith became the first patient to get the treatment at St. David’s South Austin Medical Center, after getting total body irradiation at Texas Oncology.

“The stem cells for this transplant were collected somewhere else, we don’t know where, somewhere in the world,” said Dr. Aravind Ramakrishnan, a Bone Marrow Transplant Physician. “They were collected from a donor and they were processed and taken from that donor, flown over here to Austin and then we infused the cells in our patient.”

Dr. Ramakrishnan is with the Texas Transplant Institute at the Sarah Cannon Blood Cancer Center at St. David’s South, and performed Smith’s allogeneic blood marrow transplant procedure. “This is a very important treatment for blood cancers, this is the ultimate treatment for all blood cancers, and now we’re able to do it in Austin,” said Dr. Ramakrishnan.

Up until now, patients would have to go elsewhere in Texas to get the procedure, like Houston, Dallas or San Antonio. After the treatment, they’d have to stay there for up to five months, depending on the health of the patient.

“That ability to go home for days at a time, to sleep in your own bed, and have a meal at your house, and sit on your own coach, see your kids in the morning and at night, that’s a huge psychological benefit to me,” said Smith.

Ryan Tierney, M.D., a radiation oncologist at Texas Oncology who practices at St. David’s, performed the total body irradiaiton on Ryan.

“It’s very exciting,” said Dr. Tierney. “It’s a specialized procedure and it’s something that patients used to have to go to other parts of Texas for, to Houston for example. To be able to do it close to home has a lot of benefits for the patients.”

“Just driving around Austin and seeing the traffic, you know how much nicer it is to stay close to home if you can. It’s kind of a dream come true,” said Dr. Laurence Tokaz, medical director of the Sarah Cannon Blood Cancer Center at St. David’s South.

More than 140 days after Smith got the blood transplant, he’s doing well. “I think someday we’ll look back on this time and think how did we get through that year? But you don’t really think about that when you’re called upon to face a new challenge, you just do it,” said Jennifer.

Smith hopes to one day meet the person who donated the stem cells for the transplant, to thank them for generous gift. “They have no idea what they’ve done for me and my family, it’s enormous.”

It’s easier to become a stem cell donor now than ever before. Years ago, donors had to go through major surgery, with doctors poking dozens of holes into their hips. Now injections are able to push stem cells in the bone marrow out into their blood, and an IV then takes the blood out.

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