Chapter 20: A New Department: Hematopathology

Title

Chapter 20: A New Department: Hematopathology

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Description

Dr. Bruner sketches how she worked with Dr. Hamilton to set up (in 2002/3) the Department of Hematopathology, a very unusual structure that links Lymphoma and Leukemia (and that serves 1/3 of the patients at MD Anderson.) She touches on the Department's fellowship training program.

Identifier

BrunerJM_02_20120607_C20

Publication Date

6-7-2012

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center - Building the Institution; Building/Transforming the Institution; Multi-disciplinary Approaches; Growth and/or Change; Institutional Processes

Transcript

Tacey Ann Rosolowski, PhD:

Wow. That’s impressive. Well, I’ve just a couple of miscellaneous questions but I—which are on a totally different topic—but I was wondering if there was anything that you felt you wanted to add right now to what we’ve already talked about in terms of your contributions to MD Anderson, your experiences here as a pathologist. Is there anything you feel we haven’t covered adequately?

Janet M. Bruner, MD:

The only thing I was thinking about is how in our division—one change that I did experience during the time I was a chair is that we created—Dr. Hamilton and I and his administration created a Department of Hematopathology, which is very unusual. Hematopathology is the study of leukemias and lymphomas, and in most places, the lymphomas—which are solid tumors—are dealt with in Pathology, and then the leukemias—which are blood tumors—are dealt with in Laboratory Medicine. So here, there is a huge number. I’ve heard that the amount—that the number of patients who are here with leukemias and lymphomas is like a third of our patient load. I don’t know if that’s true or not, but it’s huge. So we had pathologists in my department working on lymphomas. We had pathologists in Lab Medicine working on leukemias and they were sort of working—the tumors are so similar that they would sometimes even see the same tumor from the same patient or a similar patient, but they weren’t coordinating their efforts. At some point it became clear that it would be useful to put those people together—take them out of Pathology, take them out of Lab Medicine, put them together in their own Department of Hematopathology—so Dr. Hamilton created that, and we worked on setting it up. I want to say it was in about 2002-2003—something like that—and it was a very unusual construct at the time. I still don’t think there are many places where the leukemias and lymphomas are together with such a huge load of cases that we have.

Tacey Ann Rosolowski, PhD:

What’s been the effect of making that combination?

Janet M. Bruner, MD:

I think it’s been great because they—all the pathologists who are in Hematopathology get to work together. It’s a fellowship training program, and for a person who’s done that fellowship somewhere else—in a smaller place it’s easy to cross over, but here you were actually in two different departments. So it allows the people who’ve done that fellowship to come here as faculty members and see the full spectrum of leukemias and lymphomas and actually have the tools to work with them, because it’s also sort of a high-tech diagnostic process. They use a lot of molecular diagnostics. They use flow cytometry—a lot of really high-tech tools to help them make their diagnoses. So that’s really a different construct here, and they’ve also collaborated very effectively with our Department of Leukemia and Department of Lymphoma. So it’s sort of—again, it’s the ultimate subspecialization. We created a whole department for them because they’re so large. I think they have about twenty or twenty-five faculty now. So they’re starting from zero, and at the time the department was created, I think we transferred about four people from Pathology and I don’t know how many—maybe a similar number—from Lab Medicine. For a while they were small, but they’ve grown too.

Tacey Ann Rosolowski, PhD:

How has that influenced patient care?

Janet M. Bruner, MD:

Oh, I think it’s been tremendous for patient care because they’ve really been able to coordinate their efforts. They have a lot to do with looking at the bone marrow aspirations and really doing—they don’t do so many intraoperative frozen sections, but they have very acute leukemia patients who come into the hospital and really need an immediate diagnosis, and they start therapy right away. These leukemia patients are the sickest.

Tacey Ann Rosolowski, PhD:

That’s amazing. Well, thank you for adding that.

Janet M. Bruner, MD:

Yeah. It’s a very unusual construct, and I think it’s one that’s served us well here.

Tacey Ann Rosolowski, PhD:

Is there anything else?

Janet M. Bruner, MD:

I don’t think so.

Tacey Ann Rosolowski, PhD:

That I haven’t thought to ask?

Janet M. Bruner, MD:

Nope. Nothing. Nothing about the history.

Tacey Ann Rosolowski, PhD:

Okay.

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Chapter 20: A New Department: Hematopathology

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