Employment & Fellowships
Clinical & Research Fellows
Program Description

Leukemia & Allogeneic BMT Service (T15, VGH)

This rotation consists of two teams, each responsible for approximately eleven beds primarily used for the management of patients receiving chemotherapy for acute leukemia, or undergoing allogeneic or autologous stem cell transplantation.

This service provides experience in the primary inpatient management of patients with acute myelogenous leukemia, acute lymphoblastic leukemia, chronic myeloid leukemia, aplastic anemia, myelodysplastic syndromes, multiple myeloma, and some aggressive lymphomas. Other patients with relapsed lymphomas and solid tumors are managed during their transplant course. Experience is gained in the pre-transplant evaluation of patients and their donors, as well as in the prevention and management of regimen related toxicity, graft-vs-host disease, and the infectious complications of bone marrow transplantation.

Approximately 75-90 transplants are performed on this unit per annum; ~42% of those are allogeneic transplants from sibling donors, ~28% are allogeneic transplants from unrelated donors, and ~30% are autologous transplants. Fellows usually spend 6 to 8 months per year on this Service.

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Outpatient Intervention Clinic (CP6 Daycare, VGH)

This facility consists of 22 treatment rooms allowing a total of 30-40 patients to be evaluated/treated daily. All patients who require out-patient chemotherapy, antimicrobials, immunosuppressive agents, transfusion support or intensive follow-up pre or post-admission to hospital are managed by the fellow and staff rotating in this clinic. Experience is also gained in the use of autologous transplantation in multiple myeloma. Approximately 40 to 50 autologous transplants for myeloma are performed as an outpatient per annum. Fellows spend from 2 to 4 months per year on this Service.

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Outpatient Doctors' Clinics (CP6, VGH)

These are held Monday to Thursday for the initial review and the post-treatment management of BMT Program patients. There are 9 examining rooms and a clinic nurse assesses patients prior to them being seen by the physician. During the second year, fellows may have one clinic day a week assigned to them and are able to follow and manage outpatients under the supervision of their faculty mentor.

Night Call

While some junior housestaff participate in the care of patients during the day, the Fellow is the primary caregiver and assists the senior staff with the care of Leukemia/BMT patients. Fellows rotate first-line night and weekend call from home approximately 1 in every 5 nights/weekends, staff permitting.

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Off Service

Fellows usually have two months of 'off service' time per year. All fellows are expected to produce clinical research and the 'off service' time provides an opportunity for this endeavor. Additional experience is available by arrangement depending on the interest of individual fellows. This includes the following :

• Cryogenic and Marrow Processing Laboratory, Terry Fox Laboratory: Experience in laboratory procedures related to processing and freezing of autologous blood or bone marrow can be obtained in the Cryogenic and Marrow Processing Laboratory.

• Stem Cell Assay Service, Terry Fox Laboratory: Experience in laboratory procedures related to clonogenic assays and long-term culture of blood and marrow progenitor cells can be obtained in this laboratory.

• Cell Separator Unit, Vancouver Hospital: This 5 bed unit performs 2600 runs per year of which 25% are therapeutic plasmaphereses. The majority of runs are single donor platelet collections used for Leukemia/BMT patients. Peripheral blood stem cell (autologous and allogeneic) and buffy coat (allogeneic) collections as well as therapeutic leukaphereses are also performed. Fellows may obtain experience with the apheresis procedures in this unit.

• Immunology, Vancouver Hospital: Experience in the practical aspects of immunology related to marrow transplantation can be obtained in the Immunology Laboratory.

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