Beating Leukemia and Changing Local History

The care provided by Jane Liesveld, M.D., and others at the Wilmot Cancer Center helped Maureen Chisholm continue her family legacy.

The care provided by Jane Liesveld, M.D., and others at the Wilmot Cancer Center helped Maureen Chisholm continue her family legacy.

For Maureen Chisholm, public service was in her blood. Growing up in Buffalo in an Irish-Catholic family, Maureen saw her grandfather serve as a firefighter, two uncles as police officers, and a great uncle as Chief of Detectives for the Buffalo Police Department.

Bloodlines run deep, and it was not surprising that Chisholm pursued a career in law enforcement as well, beginning as a part-time deputy and eventually achieving the rank of Major prior to her retirement from the Monroe County Sheriff’s Department in 2003. During her tenure, she commanded the Patrol Division, Criminal Investigation Section, Internal Affairs and the Staff Services Division.

In September 2008, Chisholm made history by becoming the first female Chief of Police in Monroe County when she was appointed to lead the Fairport Police Department. Even in marriage, the connection to law enforcement was clear when she married Gene Chisholm, a New York State trooper for 20 years.

Still, despite all of her success in protecting her community, she could not protect herself from a potentially deadly form of cancer – Acute Myeloid Leukemia. Acute Myeloid Leukemia (AML) is one of the most common types of leukemia among adults, with more than 11,900 new cases occurring in the United States each year, mostly in older adults. Also called acute myelogenous leukemia, AML is a cancer that starts inside bone marrow, the soft tissue inside bones that helps form blood cells. The cancer grows from cells that would normally turn into white blood cells.

Individuals with this type of cancer have abnormal cells inside their bone marrow. The cells grow very fast, and replace healthy blood cells. The bone marrow, which helps the body fight infections, eventually stops working correctly. Patients with AML become more prone to infections, can suffer from anemia and fatigue, and have an increased risk for bleeding as the numbers of healthy blood cells decrease.

For a law enforcement officer, the chronic fatigue was a major clue that something was not right within her body. Her primary care physician sent her for blood tests which, in Chisholm’s words, came back “a little squirrely.”

“My doctor said ‘I am not taking a chance with you, whenever I see you it seems like something bizarre is going on,’” Chisholm recalled.

leukemia cells

Evidence of AML in bone marrow.

Sure enough, biopsies showed Chisholm’s platelets were not reproducing, and her doctors followed a course of watchful monitoring, ordering blood tests every three months. In May 2003, her platelet count took a severe nosedive, and she was faced with a diagnosis of AML.

“Honestly, I was not feeling that bad,” Chisholm said. “I was working full time… raising two kids…you’re going to be tired.”

Still, she remembers the concerned expression on her commander’s face when he stopped her as she was on her way to a meeting and called her into his office.

“I looked at his face and could tell something was wrong. He could not even get the words out and told me I needed to call Gene.”

Doctors had called Gene at the Chisholm home upon confirming diagnosis. They were especially concerned because Maureen was very neutrapenic, meaning her white cell count was low, leaving her prone to infection. Doctors feared the environment within her workplace would be a danger to her. Gene called Maureen’s boss immediately and asked that she be sent home.

While her family, including her son Daniel and daughter Emily, and those close to her were devastated with the news, Chisholm remained optimistic. She even thought she may have a bit of luck, or history, on her side.

“The interesting thing is that when I was four-years-old, I was repeatedly going to Strong for blood tests because they thought I had leukemia then, but it turned out to be mononucleosis. I thought ‘do I really have it this time, or did they make a mistake?’”

This time, the diagnosis was correct, yet Chisholm felt confident.

“I really had a good feeling that I was going to get through it.”

Chisholm’s attitude caught the attention of her care team at the Wilmot Cancer Center’s Samuel E. Durand Blood and Marrow Transplant (BMT) unit.

Chisholm speaking with doctors

Chisholm's strength and determination were an inspiration to her caregivers, who included (from left) Mike Ellis, M.S.W., Jane Liesveld, M.D., and Meg Blaney, R.N.

“She didn’t have an easy time with it, but she pushed through,” remembers Meg Blaney, RN, who originally cared for Chisholm while she was an inpatient on the BMT unit, and who now serves as her care coordinator. “I knew right away that this was someone really special, this was someone I would remember.”

Chisholm underwent her first Bone Marrow transplant in September 2003, receiving donor marrow from her brother, Jack Weber, but recalls not feeling well afterward. She endured a number of complications before relapsing in August 2004. Though shaken, she was not done fighting.

“When I relapsed, I thought ‘this is it,’” Chisholm recalls. “Then Gene ran into Lucy Wedow, a nurse practitioner in the BMT unit, in the stairwell and she told him that this was nothing we couldn’t handle. When Gene told me that, I stopped crying, looked at the doctor and asked ‘what do we need to do?’”

What the Wilmot Cancer Center doctors decided upon was a second transplant, a relative rarity for adult Leukemia patients.

Wilmot Cancer Center a Leader in Leukemia Research

The James P. Wilmot Cancer Center has become a regional leader in Leukemia care and research, with a special focus on cancer stem cells. Cancer stem cells (CSCs) are a hot topic in the scientific community. First identified in 1994 in relation to acute myeloid leukemia, CSCs have now been identified in several solid tumors in mice as well. Scientists who study CSCs believe they have distinct properties from other cancer cells, and may be the first cells to undergo mutations. Research from the past 10 years suggests that because CSCs may be the root of cancer, they also might provide a new opportunity for a treatment.

Michael Becker, M.D., an assistant professor of Medicine at URMC and a clinician and researcher at the Wilmot Cancer Center, last year received $240,000 from the National
Institutes of Health for a two-year investigation into the clinical relevance of stem cells involved in acute leukemia. Becker works closely with Craig Jordan (see below), and the pair authored a study Leukemia stem cells in 2010: Current understanding and future directions, which appeared in Blood Review in January 2011.

Craig T. Jordan, Ph.D., professor of Medicine at URMC and director of the James P. Wilmot Cancer Center Translational Research for Hematologic Malignancies program, is one of the nation’s foremost stem cell experts. He and and a group of collaborators are testing a new drug compound based on the feverfew plant that demonstrates great potential in the laboratory for causing leukemia CSCs to self destruct.

Jane Liesveld, M.D., is professor of Medicine and Hematology/Oncology and clinical director of the Samuel E. Durand Blood and Marrow Transplant Program at the Wilmot Cancer Center. She is an expert in the care of patients with and research related to leukemia and blood and marrow stem cell transplantation. Her research interests focus on improved therapies for acute myeloid leukemia and methods to improve the success of stem cell transplantation. She is studying how Leukemia stem cells are protected within the bone marrow environment in which they live to determine how they can be better targeted.

Kristen O’Dwyer, M.D., joined the Wilmot Cancer Center faculty last July. She is interested in clinical trials which will improve leukemia outcomes and in how leukemia cells respond to oxidant stress.

Archibald Perkins, M.D., Ph.D. (Pathology and Laboratory Medicine) is conducting research to identify unique molecular features of the leukemic stem cell that are targets for therapy with the goal of identifying an effective method to treat acute myeloid leukemia.

“Probably less than 5-10% of adult patients are able to go on to a full, second transplant,” said Jane Liesveld, M.D., clinical director of the Samuel E. Durand Blood and Marrow Transplant Center at the Wilmot Cancer Center. Liesveld was a member of Chisholm’s care team for both of her transplants, and remains in charge of her care today.
Second transplants are rare, Liesveld explained, because the disease comes back in an even stronger form when a relapse occurs and most patients are already weakened from the toxicity of some of the side effects, including chronic Graft Versus Host Disease (GVHD), from which Chisholm suffered. Graft-versus-host disease (GVHD) is a complication that can occur after a stem cell or bone marrow transplant in which the newly transplanted material attacks the transplant recipient’s body, a type of reverse process to the rejection issues faced in traditional organ transplantation.

Once again Chisholm’s brother, Jack, came up from Charlotte, NC, to provide donor marrow for his sister. And this time, the transplant turned out to be a success.

“When I got through the second transplant I felt very different, stronger than I’d ever felt,” Chisholm said.

By December 2004, she was feeling good enough to take on another job, this time as executive director of the Crisis Nursery of Greater Rochester, a non-profit organization that provided homes for children in crisis. Her return to being of service to others was a boost to Chisholm.

“I thought ‘maybe this is why I survived, maybe this is my calling.’”

In 2008, it was the Town of Fairport calling, selecting Chisholm from a highly qualified field of candidates and leading to her historic appointment as Police Chief.

Today, she returns to the Wilmot Cancer Center every four months to meet with Liesveld, Blaney and other members of her care team to go over blood work and discuss any other health concerns. She is extremely grateful for the high quality care she received from her team, particularly Dr. Liesveld.

“She is extraordinary…there are so many things that are wonderful about her,” Chisholm said. “She is always calm and reassuring. I feel so fortunate to be in her care.”

“Meg (Blaney) and Dr. Liesveld are a great pair. They have very much the same personality – very calm.”

Her interaction with Blaney, meanwhile, has led to a true friendship.

“I look at Meg as my friend – not as a nurse, but as my friend. She made me so comfortable with my situation that I felt very safe and secure, and that’s hard to come by in those circumstances.”

In summarizing her experiences with Leukemia and the Wilmot Cancer Center, Chisholm is very matter-of-fact and to the point.

“I would not be the person I am today without it (her battle with the disease). It taught me tolerance, patience and a new respect for life. The Wilmot Cancer Center is my life. I wouldn’t be here without the Wilmot Cancer Center.”