Members of the BMT Survivorship Program team.

Overview

Due to advances in bone marrow transplant practices, more individuals are living longer free of their cancer diagnosis than ever before. In this environment, the cancer experience is shifting from an acute illness to a chronic condition. We are beginning to recognize the full range of medical, functional, and psychological challenges facing bone marrow transplant (BMT) survivors. Consequently, survivorship has become a distinct phase of cancer care that requires more focused attention. Survivorship refers to the process of living with, through, and beyond cancer. Survivorship is unique for every person. Everyone has to find his or her own path to navigate the changes and challenges that occur as a result of living with cancer.

Our Mission

The goal of this program is to improve the experience and outcomes of bone marrow transplant (BMT) survivors and their families by:

  • Providing high-quality clinical survivorship care
  • Conducting innovative research to enhance the delivery, experience, and quality of life and care for BMT survivors, their families, and caregivers

Multidisciplinary Clinical Care

Survivors will be able to regularly see BMT specialists who also have expertise in other medical areas, creating a one-stop treatment plan that reduces secondary and potentially stressful doctor visits elsewhere.

Our clinical program is designed to comprehensively explore the needs of BMT survivors and their families and improve their quality of life and overall care, including:

      • Physical symptoms with emphasis on pain and fatigue
      • Psychological distress: anxiety, depression, fear of disease recurrence
      • Chronic graft-versus-host disease involving any organ
      • Physical activity and functional limitations
      • Cognitive dysfunction
      • Hormonal deficiencies
      • Bone health
      • Sleep disturbances
      • Sexual dysfunction and fertility concerns
      • Late effects of cancer therapy including cardiopulmonary dysfunction
      • Cancer prevention
      • Immunizations and infections

Innovative Research

Our research program is focused on enhancing the quality of life and care for BMT survivors and their families in the following areas:

  • Symptom Assessment & Intervention
  • Cancer Prevention & Screening
  • Communication & Treatment Decision-making
  • Education & Training
  • Patient Health Behavior and Self-Care
  • Models of Care & Health Services

Meet the Team

BMT Survivorship Core Team
Consulting Providers

BMT Survivorship Core Team

  • Areej El-Jawahri, MD

    Areej El-Jawahri

    Director, BMT Survivorship Program

    Areej El-Jawahri MD is an Instructor of Medicine at Harvard Medical School, Director of the Bone Marrow Transplant Survivorship Program at the Massachusetts General Hospital, and Associate Director of Massachusetts General Hospital Cancer Center Survivorship Program. Dr. El-Jawahri’s clinical and research interests focus on improving the quality of life and care for patients with hematologic malignancies and their families, and addressing their palliative, supportive care and survivorship needs.


  • Julie Vanderklish, NP

    Julie Vanderklish

    Associate Director, BMT Survivorship Program

    Julie Vanderdklish is a Nurse Practitioner with The Department of Bone Marrow Transplant at Massachusetts General Hospital. She has focused in bone marrow transplant as a nurse practitioner since 1999 and is the Associate Director of the Bone Marrow Transplant Survivorship Program. Julie’s clinical interests focus on the prevention and management of graft versus host disease, symptom management and improving the quality of life in bone marrow transplant survivors. Her research interests include sexual health and survivorship issues in the bone marrow transplant population.


  • Yi-Bin Chen, MD

    Yi-Bin Chen

    Director, BMT Program

    Yi-Bin Chen, MD serves as Director for the BMT program at MGH, and divides his time between patient care and clinical research with a focus on patients undergoing bone marrow/stem cell transplantation. He directs an active portfolio of clinical trials aimed to improve outcomes for patients undergoing stem cell transplantation. His interests mainly revolve around clinical care of patients underoing autologous and allogeneic stem cell transplant. He collaborates extensively with local and national colleagues as well as industry in addition to developing his own original clinical trials.


  • Jennifer D'Alotto, MSW, LICSW

    Jennifer D'Alotto

    Jen D’Alotto is a Clinical Social Worker in the BMT/Leukemia and Bone Marrow Transplant Survivorship programs at the Massachusetts General Hospital. Her practice focuses on assessing/addressing the strengths and challenges families face in coping with their diagnosis and treatment before, during, and after transplant. Her clinical interests include patient and caregiver quality of life, post-traumatic growth, mindfulness practices as stress management strategies, and developmentally-specific supports to children in adjusting to a parent’s treatment. Jen provides assessment, support, and facilitation of access to resources in clinic and in the community.


  • Jessica Driscoll, NP

    Jessica Driscoll, DNP, ANP-BC is a nurse practitioner in the Blood and Marrow Transplant Program at the Massachusetts General Hospital Cancer Center. She graduated from Simmons College with her Doctorate of Nursing Practice in 2016 as a Jonas Nurse Leader Scholar. Dr. Driscoll’s clinical and research interests focus on the psychosocial aspects of chronic graft versus host disease as it impact patients and family caregivers.


  • Chrisa Hunnewell, NP

    Chrisa Hunnewell

    Chrisa Hunnewell is a Nurse Practitioner specializing in the care of patients with Hematologic Malignancies who have undergone Hematopoietic Stem Cell Transplantation. Chrisa received her MSN from Massachusetts General Hospital Institute of Health Professions in 1995. She has been a member of the Massachusetts General Hospital transplant team since 2010. As a Hematologic Malignancies Nurse Practitioner, her clinical interests include long term complications of Blood and Marrow Transplantation, Chronic Graft versus Host Disease, Leukemia and effects of cancer on quality of life issues.


  • Michelle Jacobo, PhD

    Dr. Jacobo is the Chief Psychologist of the Medical Psychiatric Inpatient and the Director of the Dialectical Behavior Therapy (DBT) program at Massachusetts General Hospital and is an Assistant Professor of Psychology at Harvard Medical School. At MGH, she leads skills training groups, supervises, & teaches trainees about DBT. She is a senior member of the DBT consultation team at MGH, which offers as-needed consultation to other members of the MGH Psychiatry Department on challenging cases. In addition, she supervises and participates in the clinical application of mindfulness in medical populations. Dr. Jacobo’s research focuses on clinical applications of the DBT skills training model and she has been an author on several published papers in this area. A graduate of The University of Massachusetts at Amherst in clinical psychology, Dr. Jacobo has a long –standing interest in psychotherapy integration.


  • Cathleen Poliquin, NP

    Cathleen Poliquin

    Cathleen M. Poliquin is a nurse practitioner in the Bone Marrow Transplant Program at Massachusetts General Hospital. She has been with the program since its inception in 1993. She received her BS at Boston College, her MS at Boston University and her NP certificate at the Graduate School of Nursing at UMASS Worcester. She is also holds certifications as an Advanced Oncology Certified Nurse (AOCN) and Blood and Marrow Transplant Certified Nurse (BMTCN). Both these certifications are granted from the Oncology Nursing Society. She has published on the long term effects of bone marrow and stem cell transplantation and has presented at local and national oncology conferences on the long term effects of transplantation. She served as a co-facilitator for a patient/family support group sponsored by the Leukemia and Lymphoma Society for 22 years. Her clinical interests include the care of patients undergoing allogeneic and autologous stem cell transplantation, the complications and long term effects of transplantation including acute and chronic graft-vs-host disease and survivorship issues.


  • Meredith Saylor, NP

    Meredith Saylor

    Meredith Saylor has been a nurse practitioner on the bone marrow transplant team at Mass General since 2012. She received her undergraduate degree from George Washington University and graduate degree from the Virginia Commonwealth University. Her clinical interests include patients who have undergone allogeneic and autologous stem cell transplants, complications from transplantation including acute and chronic graft vs host disease and survivorship care post transplant.


  • Lara Traeger, PhD

    Lara Traeger

    Lara Traeger, PhD is a clinical psychologist and researcher at the Massachusetts General Hospital Cancer Center and an Assistant Professor at Harvard Medical School. In her clinical work and research, Dr. Traeger focuses on helping patients affected by cancer to enhance health behaviors and quality of life. She also studies strategies for enhancing resilience among cancer care clinicians.


Consulting Providers

Patient Education

As you have completed your initial cancer treatment and BMT, you might be wondering: what happens next? The answer is different for every person. Some people return to the lives they were leading before their diagnosis, while the lives of others are significantly changed by their cancer experience, the development of graft-versus-host-disease, or other issues and challenges. However, the challenge for every BMT survivor is figuring out how to return to everyday life while adjusting to the effects of their illness and its treatments.

Understanding and recognizing the challenges that face BMT survivors can help you through this time of transition. Understanding and recognizing these challenges are the first steps in developing strategies to adapt to the changes affecting your life after BMT. The goals of the MGH Bone Marrow Transplant Program Survivorship Program are:

  1. To help you prepare for life after BMT
  2. Discuss and normalize common challenges facing BMT survivors
  3. Provide helpful strategies to overcome these challenges
  4. Provide helpful strategies to enhance patients’ self-care

Challenges affecting BMT survivors

There are many challenges that can affect BMT survivors including:

  • Fatigue
  • Pain
  • Chemo-brain and neurocognitive side effects
  • Sleep problems
  • Discomfort with changes in physical appearance and self-image
  • Emotional difficulties including depression and anxiety and fear of disease recurrence
  • Endocrine and hormonal issues after transplant including bone health and thyroid
  • Changes within families and relationship
  • Going back to work
  • Intimacy and sexuality
  • Long-term follow up and prevention of cancer
  • How to best care for one self in terms of nutrition, exercise and hygiene
  • Fear of germs after BMT
  • Dealing with chronic graft-versus host disease (chronic GVHD)

Many of these challenges face all cancer survivors, but some of them are very specific to BMT survivors (such as fear of germs after BMT and dealing with chronic GVHD).

Chronic graft-versus host disease (chronic GVHD)

Chronic GVHD is a condition when the immune system can attack the body. This condition can affect any organ in the body and we will be discussing chronic GVHD in detail in one of our sessions. But the common challenges that patients face when they have chronic GVHD include:

  • Mouth pain and sensitivity to food
  • Eye dryness and eye pain
  • Skin problems and rashes
  • Joint pains and limitations to their range of motion
  • Shortness of breath and limitations in level of activity
  • Infections
  • Muscle weakness and dealing with side effects of prednisone
  • Emotional challenges of living with chronic GVHD

Our goal with the MGH BMT Survivorship Program is to cover all of these challenges and help you develop strategies to overcome these challenges in your daily life. Some of these challenges might not apply to you, but the strategies that we will discuss can help you in thinking about how to face the journey of survivorship after BMT.

A time of change

Many BMT survivors describe the first year after BMT as a time of change. It is not so much “getting back to normal” as it is finding out what’s normal for you now. BMT survivors often also say that life has new meaning and they look at things differently now. This new meaning and perspective on life often make individuals stronger and allow them a chance to reflect on what’s really important to them.

Research Programs

The Mass General Bone Marrow Transplant Survivorship Research Program focuses on enhancing the quality of life and care for BMT survivors and their families in the following areas:

  • Symptom Assessment & Intervention
  • Cancer Prevention & Screening
  • Communication & Treatment Decision-making
  • Education & Training
  • Patient Health Behavior and Self-Care
  • Models of Care & Health Services

The MGH Cancer Center Bone Marrow Transplant Survivorship Program is leading the efforts to develop innovative interventions to address the needs of BMT Survivors. Current ongoing research efforts:

  • A longitudinal study to assess chronic graft-versus-host disease symptom burden, coping, and their relationship with quality of life and distress in BMT survivors.
  • Developing a cognitive behavioral therapy intervention to reduce depression and anxiety and improve quality of life for patients living with chronic graft-versus-host disease.
  • Testing the efficacy of a web-bases BMT survivorship course on enhancing the experience and overall QOL of BMT survivors.
  • Qualitative research efforts to comprehensively understand the challenges facing bone marrow transplant survivors and their family caregivers.
  • Developing and testing a multi-component intervention to enhance the quality of life and reduce distress in family caregivers of BMT survivors.
  • A multimodal intervention to address sexual dysfunction post-transplant: a feasibility and preliminary efficacy study.
  • BMT Survivorship Program database: collecting comprehensive patient-reported outcomes on BMT survivors with a detailed needs assessments to allow for future development of targeted interventions to improve the care of BMT survivors.
Areej El-Jawahri, MD presenting at the 2016 American Society of Clinical Oncology (ASCO) meeting.

 

Contact Us

Make an Appointment

To make an appointment, please contact:
Kerri Tortora
tel: 617-726-5765
ktortora1@partners.org
fax: 617-643-5843

How to Help

Your donation to the BMT Survivorship Fund supports the program's mission to reduce suffering for survivors of bone marrow transplantation by providing outstanding clinical care and conducting research that aims to improve the delivery, experience and outcomes of survivorship care.

 

Resources

Trusted Patient Resources You May Be Interested In

Mass General Resources:

      • Mass General Bone Marrow Transplant Program

        Our Bone Marrow Transplant program is committed to developing leading-edge strategies for autologous and allogeneic bone marrow and peripheral blood stem cell transplantation for a wide variety of hematologic malignancies, solid tumors and other life-threatening hematologic disorders.

      • Mass General Cancer Center Survivorship Program

        Our goal is to promote the health and well-being of patients with cancer following completion of initial therapy.

      • Maxwell V. Blum Cancer Resource Program

        The Maxwell V. Blum Cancer Resource Program offers a range of support resources around the Mass General Cancer Center. The program has an ongoing mission to make support services, as well as respite and community-building areas, more accessible to patients and families throughout the Cancer Center.

      • Benson-Henry Institute for Mind Body Medicine

        The Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital is dedicated to research, teaching and clinical application of Mind Body Medicine and its integration into all areas of health.

      • Mass General Social Work

        Social workers are available to Mass General inpatients and outpatients through walk-in services, scheduled appointments, or by request. Tel: 617-726-2643

      • Psychiatric Oncology

        The Center for Psychiatric Oncology and Behavioral Sciences brings together experts in psychiatry and psychology to help patients and cope with the psychological and behavioral impact of cancer. Tel: 877-789-6100.

      • Parenting Support/PACT

        The clinical team of the Marjorie E. Korff PACT Program is committed to providing professional and compassionate care to families who are facing the challenges of a parent’s serious illness. Tel: 617-724-7272

      • Integrative Therapies

        Mass General's Cancer Center's support programs are designed to help patients, their families and caregivers cope with the challenges of a cancer diagnosis. We offer a wide range of integrative therapies, workshops and support groups. Tel: 617-724-6737

      • Sexual Health

        Mass General's Cancer Center's specialized clinic provides comprehensive evaluation and treatment for men and women with concerns about sexual health after a diagnosis of or treatment for cancer. Tel: 617-724-4800

      • Lifestyle Medicine

        Mass General's Cancer Center's Lifestyle Medicine Program provides personalized one-on-one consultations for any patient with cancer or a history of cancer who wants to improve their physical fitness, nutrition, quality of life or cancer prognosis. Tel: 617-724-4000

External Resources:

  • BMT infoNet

    Blood & Marrow Transplant Information Network (BMT InfoNet) is dedicated to providing transplant patients, survivors and their loved ones with emotional support and high quality, easy-to-understand information about bone marrow, peripheral blood stem cell and cord blood transplants.

  • National Cancer Institute

    Cancer.gov is the central website for the National Cancer Institute, the U.S. government’s principal agency for cancer research.

  • Look Good Feel Better

    Look Good Feel Better is dedicated to improving the quality of life and self-esteem of people undergoing cancer treatment.

  • LIVESTRONG

    LIVESTRONG unites, inspires and empowers people affected by cancer, and provides free cancer support services to anyone fighting cancer today.

  • National Bone Marrow Transplant Link

    The National Bone Marrow Transplant Link is dedicated to serving individuals before, during, and after a bone marrow or stem cell transplant.

Events

Stay tuned for information on our BMT Survivorship Workshop!

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