Her memories go back far further than two decades, but Margie Needelman celebrated her 20th "birthday" recently at the very place where she feels her life "began again."
Needelman, a survivor of non-Hodgkin lymphoma and one of Dana-Farber's early autologous bone marrow transplant (BMT) patients, was back at the Institute to celebrate the event on April 15 (2008) - exactly 20 years after her transplant - with cake and caregivers. Swapping wisecracks with her physician, Lee Nadler, MD, and hugs with her nurses, the Illinois resident was lymphoma-free, just as she's been since having the then-experimental procedure as part of a 150-patient study treated at the Institute by Nadler and Arnie Freedman, MD.
"After I was diagnosed with advanced cancer, a doctor in Chicago told me I'd be dead in eight years and there was nothing I could do about it," says Needelman, 62. "That wasn't good enough for me. I told them if they could show me where it was written that I wasn't going to make it, that's fine. But if not, I wasn't going to give up."
Her husband Jerry, a veterinarian, researched lymphoma treatment options, and "the name Dana-Farber kept coming up." Needelman could not find a match for an allogeneic transplant, in which healthy tissue from a donor (often a relative) is inserted into a patient's bloodstream after he or she undergoes high-dose radiation and chemotherapy.
At Dana-Farber, however, Nadler and Freedman headed a team that was among the pioneers in autologous transplants, in which a patient's own tissue is extracted, harvested, and then reinfused after treatment.
"She was not a candidate to have a conventional autologous bone marrow transplant because her marrow was contaminated with lymphoma cells," says Nadler, now senior vice president for Experimental Medicine and director of the Center for Clinical and Translational Research at Dana-Farber. "We used monoclonal antibodies developed in our laboratory to "purge" the lymphoma cells and give her the opportunity to be treated with a curative intent."
The transplant procedure and its aftermath, Needelman recalls, was arduous but exciting. "I remember the nurses singing 'Happy Birthday' as my marrow dripped back in," she says with a laugh. Today autologous patients can be out of isolation at Dana-Farber/Brigham and Women's Cancer Center in two weeks or less, but back then it was 29 days until Needelman was able to leave her room. She savored the weekend visits from her husband and phone calls with her then-12- and 15-year-old sons.
Once back in Illinois, Needelman moved on with her busy life as a wife, mother, certified cash manager, and after some additional schooling earned her CPA. Currently she is a court-appointed special advocate helping abused and neglected children. But Dana-Farber has never been far from her mind. She got a dog she named "Dana Lee" in honor of the Institute and Nadler, and for the past nine years she's scheduled her annual check-ups at Dana-Farber in the fall to coincide with the Boston Marathon® Jimmy Fund Walk so she and her family could take part. "Team Margie Needelman" has raised more than $80,000 for the Institute, and Nadler and other caregivers have taken some of the 26.2-mile treks alongside her.
On a framed photograph of the Needelmans taken during last year's Walk, and presented to Margie and Jerry during their April 15 visit, Nadler inscribed this message: "The impossible is possible. Now we celebrate a decade at a time."
Needelman says that sounds just fine to her, and she's already planning to be back in 2018 for some more cake. In the meantime, she has a new jewelry business and grandkids to keep her busy.
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