Long-Term Follow-Up

Paul Carpenter, MD

Paul Carpenter, M.D.

Inside the austere white binders that line the shelves of Dr. Paul Carpenter's office, you'll find plenty of study records and technical data, but you'll also find something else — his heart.

Interspersed with the research annals, mementos from grateful patients spill forth from notebooks: Christmas cards, school photos, notes of heartfelt thanks, graduation announcements and more. All are poignant reminders of Carpenter's calling and motivation as a healer.

But the role of healer takes Carpenter beyond hands-on contact with the infirm. As the only Clinical Research Division clinician with a foot in both pediatric and adult camps, Carpenter's duties shift between pediatric bone-marrow transplant patients, long-term follow-up care for both adult and pediatric patients and research, mainly focused on graft-vs.-host disease (GVHD). He's helped make key advances in treating this sometimes life-threatening transplant complication.

Carpenter left his native Australia to come to the United States in 1995 as part of the University of Washington's hematology fellowship program and began his work at the Hutchinson Center. He says he has found the perfect balance in his professional aims at the Center. Every other month, he dons his physician hat and sees patients full-time: children at the Seattle Cancer Care Alliance clinic or LTFU patients. He also fields phone calls from physicians around the country who have care questions about their patients previously treated at the center.

On opposite months, he hangs up his stethoscope and reconnects with research. He finds it inspiring to be part of improving care through clinical studies. His efforts mainly focus on GVHD, a potentially life-threatening post transplant complication in which the donor T-cells recognize the transplant recipient's tissues as foreign and attack them.

Patients with GVHD are often treated with steroids, but long-term use of these drugs can bring many deleterious side effects. Carpenter recently launched a new study to more rapidly taper steroid exposure by adding a steroid-sparing agent to the pharmaceutical mix. "We hope that by adding just the right amount, we can achieve the goal of significantly reducing patients' steroid exposure, which should have important downstream benefits, such as reducing infection risk and decreasing complications like diabetes and bone disease," he said. "We hope this will ultimately lead to better survival."

Carpenter, in collaboration with Dr. Jerry Radich, recently finished a study examining the use of Gleevec, a targeted-therapy drug, within the first 100 days of transplant in high-risk patients with leukemia. He's also analyzing the results of a trial he led to study how well the drug sirolimus works as a secondary therapy in treating patients with chronic GVHD that has not responded to previous systemic treatment.

While Carpenter admits that patient care can be exhausting, the rewards keep him going. "Working in one-month rotations as an attending physician can be grueling, but there's something very satisfying about coordinating a team that is dedicated to doing the best thing for the patient. I love interacting not only with the patients and families, but also with the members of the team," he said.

For his efforts, Carpenter was recently lauded by his Clinical Research Division and Seattle Cancer Care Alliance colleagues. The physician-researcher was awarded his division's 2006 Al-Johany Award for excellence in patient care at the Sept. 12 grand rounds. The annual prize honors a Hutchinson Center physician who has provided exemplary clinical medical care and compassion on behalf of the Center's patients and their families. But he is quick to recognize the dedication of others on the team.

"None of us practices in a vacuum," he said. "When I look back on all of the interactions that are so critical for patient care, it's not just my work. It's the combined effort of a unique and talented care team."

Fred Hutchinson Cancer Research Center is a world leader in research to prevent, detect and treat cancer and other life-threatening diseases.