Originally created 07/24/97

Intensive therapy



Lying on her back in the hospital bed, a blue cloth covering the tubes that ran out of her chest, Wanda Attaway couldn't see or feel it as her blood was drained out of her by a machine and then pumped back in.

But she could taste it.

"It tasted like saline, salty," she said, pulling a sour face.

The tubes drew her blood to a machine that separated out stem cells and collected them in a plastic bag that slowly filled with pink liquid before the blood was returned. After four days of intensive chemotherapy, the cells would be put back into her body to speed her recovery from cancer.

Mrs. Attaway, 45, is an Augusta pioneer. She is the first to complete an autologous stem cell transplant at a new unit of Medical College of Georgia. It's a role she never dreamed she would have.

During a routine mammogram on Jan. 7, doctors noticed unusual masses in both breasts. A couple of weeks later, they took tissue samples and found a small benign lump in the right breast. The left breast was a different story. When it was removed, doctors found a cancerous tumor 11/2 centimeters long. Further tests revealed it had spread to 10 lymph nodes, said Anand Jillella, who heads up the new transplant unit.

"Cancer was the furthest thing from my mind," Mrs. Attaway said. A sister-in-law died last year after a 13-year battle with breast cancer, and a friend from church had also fought breast cancer and received a stem-cell transplant at Emory University in Atlanta.

Mrs. Attaway's timing was better - MCG was just putting into place the new transplant center on the fifth floor of the hospital. The unit allows patients with breast and ovarian cancer, lymphoma and myloma and other cancers to receive chemotherapy 10 times more powerful than standard chemotherapy, Dr. Jillella said.

Those cancers are generally more sensitive to chemotherapy, and using a high dose right away seems to reduce the chance of cancer returning, Dr. Jillella said. Some studies have shown that the therapy reduces the rate of breast cancer recurring from 80 percent to 30 percent, Dr. Jillella said. That is especially important with breast cancer, in which 90 percent of recurrences are fatal, he said.

The stem cell, stored in the bone marrow, can play an important role in the patient's survival. The cells are known as the "mother" or "parent" cells because they produce other blood cells, such as red blood cells that carry oxygen, platelets, and the white blood cells needed to fight off infections. Usually devastated by chemotherapy, the cells used to be replaced by bone marrow transplants that required a longer recovery time. Now the cells themselves can be removed from the blood - Mrs. Attaway had 5 million stem cells removed by the machine before her blood was returned to her body - and then stored at minus 91 degrees Fahrenheit in a special liquid nitrogen refrigerator.

After 96 hours of intensive chemotherapy, Mrs. Attaway's stem cells were removed from the freezer, warmed in a water bath to blood temperature, and then injected back into her body. And again, the taste returned.

"It smelled and tasted like tomato soup or canned tomatoes," she said. What she was actually smelling and tasting is a preservative added to the blood to keep the cells from being damaged by freezing, Dr. Jillella said.

Unfortunately, it was the last thing she tasted, at least for a while. The intensive treatment destroyed her taste buds, she said.

"I can smell what I'm eating, but when it gets in my mouth, that's when it loses its flavor," she said.

Her brown hair - "long," she sighed - has also disappeared and her head is now covered by a red bandana. The children she works with in day care at Curtis Baptist Church have taken it well and actually brought her some "do-rags" like the bandana to cover her head. That she can sit at home on her couch and tell her story just a couple of weeks after her chemotherapy is the biggest advantage of the new center, she said.

She was able to do much of the treatment on an outpatient basis before she finally went into the hospital for the harvesting, she said.

"If I'd been at Emory, I would have been in the hospital or living in a motel," she said. Even when she was in the hospital, "my husband was able to stay at work and come (visit) at night," she said. Friends could also drop by, though after the chemotherapy no one with a cold or sniffles could come in and visitors had to wash their hands, she said.

She was in the hospital a total of 19 days, and her immune system recovered so quickly after the transplant that she was able to go home 13 days later, a remarkably quick time, Dr. Jillella said.

The less time patients spend with a depressed immune system, the less danger of developing dangerous infections, Dr. Jillella said.

"Every day that your immune system is so low, every day is not a day, it's a big hurdle," Dr. Jillella said.

Six more patients are scheduled to undergo the treatment, and eventually the center hopes to do 50 a year. Being the first strikes Mrs. Attaway as almost divine intervention in her suffering.

"I just didn't think God would bring the program to Augusta and then send me to Emory," she said. "A lot of prayers are answered."