Yan Cheng, Ph.D.

Yan Cheng, Ph.D., is an instructor for the UAMS Winthrop P. Rockefeller Cancer Institute’s Myeloma Center.

Cheng, who joined the Myeloma Center team in 2021, conducts translational research, including identifying the biology of multiple myeloma risk genes. Her research focuses on unravelling the mechanisms of resistance to therapy to help develop new immune treatments for various forms of myeloma.

Cheng, who works under the guidance of Fenghuang (Frank) Zhan, M.D., Ph.D., in maintaining the center’s mass cytometry, is a mentor to several students. An alumna of China Pharmaceutical University, Cheng received the 2022 Winthrop P. Rockefeller Cancer Institute Research Retreat Outstanding Postdoc Poster Award.

Fumou Sun, Ph.D.

Fumou Sun, Ph.D., is an instructor for the UAMS Department of Internal Medicine and the Winthrop P. Rockefeller Cancer Institute’s Myeloma Center.

He earned his doctorate from China Pharmaceutical University in the spring of 2019.

His primary role for the Myeloma Center is finding and identifying potential myeloma treatment targets and designing novel therapeutic strategies.

Additionally, Sun has used his expertise of antibody engineering and multiple myeloma immunology to establish the chimeric antigen receptor (CAR) T-cell platform for the Myeloma Center lab. Sun is the creator of the antibody screening platform currently used by the facility.

Sun, who has been with the center since August 2021, works under the tutelage of Fenghuang (Frank) Zhan, M.D., Ph.D. Due to his excellence in research, Sun earned the 2022 American Society of Hematology (ASH) Abstract Achievement Award and has been invited by the ASH Program Committee for presentation in an oral session at the 64th ASH Annual Meeting.

The challenges that come with receiving extended medical care can be overwhelming. There are many factors that must be addressed before patients are prepared to receive care. This requires creating a healthy environment where a patient need not worry about how they will get to the hospital, where their meals will come from and, maybe most importantly, where they will rest.

Receiving treatment for diseases such as myeloma requires lengthy care and must be done in a specialized facility like the University of Arkansas for Medical Sciences (UAMS). For many people, housing away from home can be a costly barrier.

“Coordinating the details of receiving cancer treatment away from one’s home in another city or state can be challenging, and we are very lucky to have nearby facilities which offer safe, clean and economical lodging options for our patients,” said Harold Dean, MSW, LCSW, OSW-C, social work program manager for the Myeloma Center. “Over the years, so many of our myeloma patients have expressed their gratitude for these facilities, saying that staying in these facilities helped decrease their anxiety and allowed them to focus on their healing.”

20th Century Club of Little Rock
4011 Maryland Ave., Little Rock

Founded in 1941, the 20th Century Club of Little Rock was created to support the American Red Cross and the United Service Organization during World War II, largely by making bandages and clothing, and suppling food items. Later, the nonprofit’s activities would evolve to cancer support.

In 1984, the nonprofit organization purchased a historic home in Little Rock’s Quapaw Quarter neighborhood to provide lodging for cancer patients. Known as the Hope Lodge, it became a symbol of the 20^th Century’s Club’s compassion for those receiving cancer treatment. The organization sold the Hope Lodge and began work on creating a larger facility, which opened in 2011.

Located across I-630 from UAMS, the 20th Century Club’s Lodge provides comfortable housing at no cost for up to 21 patient and caregivers, while offering various forms of support such as access to healthy food and community guidance. Overnight stays at the lodge are primarily funded through donations from the community and corporate sponsors. The organization also hosts the Hope Ball, a popular annual gala that supports its activities.

Home for Healing
4300 W. Markham St., Little Rock

In the 1990s, a group from the Arkansas Cancer Research Center Auxiliary was inspired by the Donald W. Reynolds Cancer Support House in Fort Smith, which provided housing for cancer patients and their families. Understanding that there was a critical need for a similar facility in Little Rock, Kent Westbrook, M.D., who served from 1984-1999 as director of what is now the Winthrop P. Rockefeller Cancer Institute, met with Sam Perroni, a founding member of the Ronald McDonald House, about providing affordable housing similar to what was offered through that organization, but for cancer patients and parents of newborns in intensive care at UAMS.

This was the inception of the Family Home of Little Rock, now known as Home for Healing, which opened in 2003. The nonprofit organization offers no-cost housing for patients and their families receiving treatment at UAMS, Arkansas Children’s and many other local hospitals. Located across Markham Street from UAMS, the 13,500-square-foot house offers guests full amenities including a full kitchen, a laundry room and living rooms. 

The organization has housed more than 5,000 people from Arkansas, 35 states and at least seven countries.

Goodness Village
11610 Pleasant Ridge Road, Little Rock

Due to Little Rock being a health care destination for many Arkansans, it was clear that there was a great need for affordable short- and long-term housing for patients traveling to the capitol city. Out of this demand, Home Away from Home, founded through the Little Rock Church in 1995, provided housing for patients receiving bone-marrow transplants. 

Now known as the Goodness Village, the nonprofit organization provides affordable housing for those experiencing home displacement emergencies and patients receiving medical treatment. Located in west Little Rock just off Highway 10, the facility includes 20 fully furnished apartments with plans to add more units.

The organization relies on a large volunteer network that provide guests with services such as transportation to appointments and food deliveries.

There are many other facilities where patients can stay and these are found on our website (https://uamshealth.com/patients-and-guests/food-and-lodging/hotel-accommodations/).

Retired attorney James Jaquess can’t say enough about the care he received at the University of Arkansas for Medical Sciences (UAMS) Myeloma Center. In fact, UAMS features prominently in his book “Multiple Myeloma: A Journey to Remission.”

Jaquess is being treated at UAMS as well as at the Emerald Coast Cancer Center in Fort Walton Beach, Florida.

“The book gives you an opening into what myeloma is,” said Jaquess, who lives in the community of Santa Rosa Beach, about 25 miles east of Fort Walton Beach on Florida’s Gulf Coast. “The intent of the book was that going to UAMS saved my life.”

Jaquess’ path started with what he thought was a simple back issue.

“In March 2018, I thought I had a pinched nerve in my back,” Jaquess said. “I had those episodes before, I would take muscle relaxers, and the pain would go away. This pain never went away, and it kept getting worse and worse.”

One of Jaquess’ daughters contacted a nurse, who in turn recommended he contact Robert Feldman, M.D., a neurological specialist in Fort Walton Beach.

“He took X-rays and told me one of my vertebrae was cracked,” said Jaquess. “He also told me he pulled a sample of my bone marrow, found something he didn’t like, and referred me to an oncologist.”

That oncologist was Y. Henry Hsiang, M.D., Ph.D., who gave Jaquess the diagnosis.

“He told me I had multiple myeloma — I didn’t even know what myeloma was,” Jaquess said. “He explained that my bone marrow was at 60% abnormality, but it was confined to just my bones. He referred me to UAMS, and said it was the best place for treatment of myeloma.”

Coming to UAMS was not Jaquess’ first time in Arkansas. He notes in his book that he had taken many business trips to the Arkansas Nuclear One plant in Russellville.

The initial meeting at UAMS took place in early June 2018.

“I flew out on my initial trip,” said Jaquess. “There was an article about UAMS in a magazine on the plane featuring a lady who was in her 25th year of remission. I thought that was positive.”

“I was really impressed when I came to UAMS,” Jaquess continued. “I was given a three-ring binder that had everything I needed to know. We had an initial meeting with the doctors, staff and administrative people. It was really good — the insurance people were there and they handled everything.”

Sharmilan Thanendrarajan, M.D., is currently in charge of Jaquess’ treatment.

“Mr. Jaquess underwent an intensive treatment protocol, including induction chemotherapy, high-dose chemotherapy with autologous stem cell transplantation, followed by maintenance therapy,” said Thanendrarajan.

Jaquess’ routine now includes teleconferences with Thanendrarajan and DARZALEX (daratumumab) injections in Fort Walton Beach. Daratumumab is a monoclonal antibody for patients with multiple myeloma.

“It used to be a three to four-hour process by IV every month,” said Jaquess. “Now it’s just a five-minute injection into my abdomen every other month.”

Jaquess’ most recent trip to UAMS was in February, and he noted that no traces of myeloma came back on his tests.

“He qualifies as stringent complete remission,” Thanendrarajan said. Stringent complete remission is the best response possible regarding a patient’s multiple myeloma treatment.

Jaquess praised the process when visiting UAMS.

“I go in one day and have all of my procedures done. Sometimes I’m there until 7 or 8 p.m., but I don’t care because I want it done. The next day I can see Dr. Thanendrarajan, and then I can leave. I’m only there for two days, and it’s amazing to get that much work done.

“One of the things about UAMS that really stands out is the Myeloma Center. If you have to have a CT scan or an MRI, you just go down the hallway or around the corner. If I was in Florida, I would have to go to a different hospital or wait for two days to get in.”

For Jaquess, the book was another form of therapy.

“Everything I had read about myeloma had been negative. The drugs today are so much different, and I wanted people to see what I went through and how I progressed,” said Jaquess. “I don’t feel like I have any problems at all.”

Characterizing the role of the immune microenvironment in multiple myeloma progression at a single-cell level

Blood Advances
November 2022
Primary author: Carolina Schinke, M.D.

Multiple myeloma (MM) is preceded by precursor stages including MGUS and smoldering myeloma. It is thought that the acquisition of mutations in the myeloma cells is responsible for disease progression through these stages. In this study, Dr. Schinke and colleagues study the bone marrow micro-environment, which are the non-myeloma cells of the bone marrow. The main premise of the study is that early alterations within the bone marrow microenvironment such as changes in immune cells contribute to the progression of multiple myeloma from its precursor stages. Identification of these changes in the immune system may be the key to identifying novel treatment approaches. Using a novel technique, Schinke, et al sequenced the genetic material in single cells from the bone marrow environment from monoclonal gammopathy of unknown significance, smoldering MM, and newly diagnosed MM patients. Changes in immune cell compostion were found such as a substantial decrease in memory and naïve help T-cells. There was also in and T-regulatory cells, which dampen the immune response. These alterations were further accompanied by an enrichment of nonclonal memory B cells and an increase in CD14 and CD16 monocytes in MM compared with its precursor stages. These early results provide crucial information on the immune changes associated with the progression to clinical MM and can help to develop immune-based strategies for patient stratification and early therapeutic intervention.

Concomitant deletion of the short arm (Del 1p13.3) and amplification or gain (1q21) of chromosome 1 by fluorescence in situ hybridization are associated with a poor clinical outcome in multiple myeloma

American Cancer Society Journals
June 2023
Primary author: Maurizio Zangari, M.D.

On the long arm of chromosome 1, genes are located that control cell growth and survival. For over two decades our group has drawn attention to the fact that multiple copies of these genes on chromosome 1 confer a poor prognosis. This has recently also been recognized by the International Myeloma Working Group. In this paper, Dr Zangari and colleagues focus on the loss of the short arm of chromosome 1 in 1133 patients treated on Total Therapy trials. Loss of the short arm of chromosome 1 occurred in 20% of patients and was associated with high risk features and worse survival. The presence of abnormalities of both the long and short arm of chromosome 1 was an especially poor feature. We have previously identified 70 genes by gene expression profiling that predict a worse outcome; many of these genes are located on chromosome 1. In the present study, fluorescent-in-situ hybrization (FISH) was used to detect chromosome 1 abnormalities. FISH is a widely-available technique compared to more complex gene expression profiling, and this knowledge will improve risk prediction for many myeloma patients. In addition, this study shows that it is not only the presence of abnormalities of the long arm of chromosome per se which is a poor prognostic predictor, but the context in which it occurs matters together with the loss of the short arm of chromosome 1.

Heather Brown, APRN, a nurse practitioner for the University of Arkansas for Medical Sciences (UAMS) Winthrop P. Rockefeller Cancer Institute’s Myeloma Center, appreciates the opportunity to serve the patients.

A 2001 graduate of the UAMS College of Nursing, Brown quickly learned about myeloma as the center opened shortly after she was hired by the institute. In the early days, the center was in a trailer where research about myeloma, and administering of the various treatments, took place.

“Drugs that are now standard care for our patients were research protocols at that time,” she said. “I love how much we’ve evolved in terms of treatment for myeloma patients in 22 years. The things we now do are much more streamlined, easier on the patients.”

Brown vividly remembers working on the floor of the center, which by this time, was in the UAMS Ward Tower. Brown’s tenure on the floor helped her eventually transition into an APRN role.

“I was already familiar with myeloma, the treatments, side effects of the treatments, supportive care specific to myeloma,” she said. “However, sometimes I miss working on the floor, the caregiving part of nursing.”

“There are patients I took care of many years ago who are still in touch with me,” Brown said. “There are also family members of our patients who still keep in touch with me.”

Brown sometimes sheds tears when thinking of patients who are now deceased.

“With all the new treatments and options, I wish they would’ve survived a little longer,” she said. “We now have more treatments that would’ve helped them overcome myeloma.”

Wendy Bowen was just 38 years old and in her fourth year of working as a pediatrician in Jackson, Tennessee, when severe chronic fatigue forced her to retire in March 2003.

She had been diagnosed six months earlier with multiple sclerosis (MS), and it seemed to be rapidly taking its toll.

Then one morning about three years later, she awoke to a new symptom that left her puzzled: a deep ache in both of her shoulders.

“I felt like I had worked very hard the day before,” she said. But she couldn’t think of anything she had done to prompt the discomfort.

When the ache wouldn’t go away, she went to her doctor, who ordered some bloodwork that produced some “strange labs.”

Her doctor sent her to a rheumatologist, who in turn sent her to an oncologist.

By October 2006, a slew of additional tests that included a bone marrow biopsy resulted in a definitive diagnosis: multiple myeloma, a rare cancer of the plasma cells, which are cells in the bone marrow that produce antibodies. Although these white blood cells normally protect the body from germs and other harmful substances, somehow they had malfunctioned and multiplied, overproducing one particular plasma cell line.

The myeloma cells tend to collect over time in the bone marrow and in the bones, and often cause pain, fractures, fatigue, and can render the bone marrow unable to do its main job, making blood cells of all kinds. Bowen said that cancer is a known possible side effect of the immunosuppressive MS therapy she was taking.

Her diagnosis was nonetheless surprising for a 41-year-old white woman, as myeloma is much more common in people who are male, Black and between the ages of 65 and 74.

Bowen’s oncologist gave her the name of three hospitals in the region that could perform a stem-cell transplant, regarded as the gold standard for myeloma, and she chose UAMS, a 3½-hour drive away. 

At the time, the youngest of her three children, a girl, was just 8 years old. Her oldest, a boy, would be graduating from high school. She said her husband, Mike — her high school sweetheart with whom she celebrated 39 years of marriage on April 14 — quickly agreed to be her caregiver, and they spent the better part of 10 months in Little Rock while she underwent myeloma treatment, including two stem-cell transplants in 2007.

Myeloma mutates to survive, forcing her to undergo a third stem-cell transplant in September 2018, which kept her in remission for about a year.

By 2021, she said, “None of the therapies were working anymore. Then I found out that CAR T-cell treatment had been approved by the FDA in March.”

She was referring to chimeric antigen receptor (CAR) T-cell immunotherapy, a new cutting-edge procedure in which patients experiencing relapsing myeloma are given infusions of their own genetically enhanced T-cells, a type of immune cell. The modified cells expand, multiply and seek out myeloma cells, and kill them.

Frits van Rhee, M.D., Ph.D., clinical director of UAMS’ Myeloma Center, has overseen her treatment from the very beginning in 2006. He was one of the few physicians, and UAMS one of the few centers in the South, allowed to perform this procedure. His staff began work immediately to perform the long list of things that have to be done to obtain ABECMA, the name of the genetically modified cells. On Nov. 15, 2021 — five months after her insurance company began covering the procedure and three months after UAMS gained approval to provide it — she became the third UAMS patient to undergo it.

“Several weeks before the treatment you have your T-cells collected using a machine much like what is used to donate plasma at a blood donation center. The cells are mailed to the drug company’s lab, where they attach a protein ‘key’ that will only attach to myeloma cells. Once your cells are ready you have a port placed, have three days of chemotherapy required to prep your bone marrow for the arrival of these ‘killer cells.’ After being admitted to UAMS, they hang the bags like any IV infusion, hook it up to your port, and infuse it. That’s it!” she said. “I think the whole thing took maybe an hour or two. Then you just wait.”

Bowen said she was feverish for a good 12 hours a day after the procedure. This reaction was fully expected to happen, and the medicine in the protocol for it was administered, and “by the third day, I felt fine.”

She was discharged on the seventh day, and on the 30^th day of remaining within an hour of the hospital, as required, “My husband drove me home to Tennessee.”

Her first follow-up positron emission tomography (PET) scan a few months later at UAMS showed no sign of the myeloma and her bone marrow showed no plasma cells, indicating that the CAR T-cell therapy was working.

A year and a half later, at age 58, she appears to be free of both myeloma and MS.

“I feel wonderful,” Bowen said. “I haven’t felt this good since before I was diagnosed with MS. I just feel like myself again.”

She loves that no follow-up treatments are needed, and said she enjoys spending time with her grandchildren and catching up on home projects.

“I can’t imagine getting any better care than I got at UAMS,” she said. “They have great doctors, but it’s not just the doctors. The whole team at the Myeloma Center at UAMS is wonderful. This is what they do. The environment is so myeloma-friendly. You know you can trust them.”

(Left to right) Christy Bunting, Amy Ford, Melissa Thomas, April Thomas.

For new patients of the UAMS Myeloma Center, the intake process provides their first impression of the support they’ll receive during a difficult period of their lives.

“It’s important that we help them get established and make sure they’re comfortable coming here,” said Christy Bunting, an intake coordinator in the Myeloma Center. “We want them to know that they can relax because our doctors and staff are going to take care of them. They’re in the right place.”

Bunting and fellow intake coordinator April Thomas serve as the initial points of contact for any patient referred to the Myeloma Center. They gather medical and insurance records so the center can confirm the patient’s myeloma diagnosis and get insurance-company approval for a round of tests that help determine the best course of treatment.

Once they’re approved to proceed, Bunting and Thomas work with the patient to schedule an appointment that comprises three days of testing and a day of consultation with a doctor. The goal, barring any insurance delays, is to have each patient in for testing within 14 days of initial contact with the intake team.

“That’s not always feasible because of the insurance verification process, but we’re always trying to get our patients here as quickly as we can,” Thomas said.

When patients arrive at the Myeloma Center, they’re welcomed by intake nurses Melissa Thomas, RN, and Amy Ford, RN. The intake nurses help navigate the testing schedule and gather details about the patients’ health histories. That information is summarized for the doctors to give them a clearer picture as they map out a treatment plan.

“Some of our patients have received treatment before they get here,” Ford said. “In those cases, we input their outside results from bone marrow tests, lab work or radiology to help our doctors see where the patients started and where they are now.”

Intake nurses also address any immediate medical issues — such as pain or abnormal lab results — that arise as the patients arrive and undergo testing.

Melissa Thomas noted that the Myeloma Center sees patients in all stages of the disease. Many of them are experiencing significant pain, she said. For some, the disease has progressed to a point where they are using a wheelchair or are struggling to walk.

“The main thing for us is to help our patients and get them through the testing process,” she said.

The intake team members also recognize the emotional struggles that patients are going through. Bunting said she and her colleagues see people at their lowest points, and it’s important to be a voice of reassurance and kindness for patients who might feel anxious or overwhelmed.

“We give the same treatment to all of our patients,” Bunting said. “They’re all VIPs, and we try to do our best for each one of them.”

Bunting, April Thomas and Melissa Thomas have all worked in the Myeloma Center for about 20 years. Ford, a relative newcomer, started working at the Myeloma Center in 2006 and joined the intake team in 2012. This continuity provides an extra measure of comfort for patients, some of whom return to the center years after their initial treatment and find familiar faces to guide them.

Ford said the intake team has a vital role in ensuring that patients have a positive experience at the Myeloma Center.

“I think a lot of people like having that one-on-one contact as we help them understand this process,” Ford said. “We might have to explain things four or five times, but that’s OK with us. We want to let them know that someone’s here to intercede for them in any way possible.”

The University of Arkansas for Medical Sciences (UAMS) Winthrop P. Rockefeller Cancer Institute continues to make progress on achieving National Cancer Institute (NCI) designation, a recognition given to cancer centers that meet rigorous standards for state of the art research, cancer prevention and treatment. 

More than two-thirds of funds awarded by NCI for research and clinical trials go to NCI-designated centers. Designation also is expected to create 1,500 new jobs and have an economic impact of $72 million annually. 

UAMS held the first in-person meeting of its External Advisory Board (EAB) in March with leaders from designated cancer centers, including the Dana Farber Cancer Institute, University of Chicago Comprehensive Cancer Center, University of Kansas Comprehensive Cancer Center, Chao Family Comprehensive Cancer Center and more.

The world-renowned Myeloma Center sets UAMS apart both in research and clinical care, making it the crown jewel of the translational science component of the NCI application. 

Under the leadership of Director Michael Birrer, M.D., Ph.D., the Cancer Institute has focused largely on recruiting top research and clinical talent from across the country, hiring 25 new researchers and seven oncologists in the last two years. These researchers will help broaden and deepen the institute’s research efforts with the goal of producing measurable clinical outcomes for patients. 

Donors have contributed more than $20 million toward NCI-designation efforts. UAMS also has received amazing support from the Arkansas legislature with a new allocation of $50 million over two years to support NCI-designation efforts.

The launch of the Community Outreach and Engagement Program has expanded the Cancer Institute’s statewide reach. This program has already helped more than 1,000 people living in rural, underserved parts of the state.

This fall, UAMS took another big leap with the opening of the Proton Center of Arkansas, the state’s first and only provider of proton beam radiation therapy for children and adults with solid tumors. 

As UAMS pushes forward to NCI designation, the Myeloma Center and other cancer programs will only grow in their impact on patient’s lives.

The Cancer Clinical Trials program at the UAMS Winthrop P. Rockefeller Cancer Institute is undergoing a massive expansion in preparation for National Cancer Institute (NCI) designation, an elite status given only to cancer centers on the forefront of cancer research.

Though they often operate quietly behind the scenes, clinical trial programs are essential in moving new cancer treatments from the lab into the clinic to help patients. Chimeric antigen receptor (CAR) T-cell therapy is just one example.

NCI sets strict requirements for the way clinical trial programs are organized and operate. In its pursuit of designation, the Clinical Trials Office at UAMS is in constant continuous improvement mode.

The office has grown from a staff of 35 to 60 in the past two years, with plans to add another 10 people in the coming year. The team is busier than ever, managing 260 active trials to date. Six first-in-human Phase 1 trials are currently underway in the newly dedicated Phase 1 Clinical Trial Unit including trials for myeloma.

“There is great institutional support here at UAMS for cancer clinical trials,” said Michael Birrer, M.D., Ph.D., director of the Winthrop P. Rockefeller Cancer Institute and principal investigator of 16 clinical trials himself.

The office is working closely with UAMS’ eight regional campuses and the Rural Research Network to improve access to clinical trials across the state, especially among rural, underserved populations in Arkansas.

 “We have a great team in place that collaborates really well,” said Matt Kovak, director of the Clinical Trials Office. “We’re ready to scale up in-patient enrollment and improve access to trials all over the state.”

Many patients at the UAMS Myeloma Center have relapsed refractory myeloma, meaning they have nearly run out of effective treatment options. Fortunately, the center has talented clinical researchers like Carolina Schinke, M.D., with access to the latest medications, including promising study drugs.

Schinke is leading a clinical trial at UAMS of a promising new bispecific antibody drug, talquetamab, which was approved by the Food and Drug Administration in August of 2023.

Bispecific antibodies influence the immune system, activating a patient’s own T-cells to kill their cancer cells.

“It’s not a curative drug, but we’ve had relapsed refractory patients responding for up to a year or even longer, and that was amazing,” Schinke said.

UAMS enrolled 16 patients in the study, the highest of any site in the national study, with more than 70% of participants responding positively to the drug, which Schinke called “impressive.”

By May 2023, the Myeloma Center had three open studies for bispecific antibody therapies and three more in the pipeline. The additional studies have different molecular targets. So far, all of them are showing about the same level of effectiveness, Schinke said.

Although patients’ myeloma may return, the bispecific antibodies buy precious time for the development of new drugs, or even allowing the reuse of another myeloma therapy.

“This new class of drugs is enabling us to provide a bridge to other treatments,” Schinke said. “When they relapse on a bispecific antibody treatment, it doesn’t mean that’s the end. In fact, because of their break from a prior treatment, they may be able to return to that therapy.”