Wendy Hamilton

Photo courtesy of Wendy Hamilton

On a peaceful, crisp morning in Northern California, Wendy Hamilton sat on a rock overlooking the valley in a state park near Lake Tahoe. As she gazed at Mother Nature's beauty, sipping a bottle of spring water, she made an entry in her journal:

"Thank you God for letting me take this wonderful trip with my daughter. I am so thankful for this time with her, your many natural beauties in the world, and the rich blessings in my life."

As the sun serenely rose over the cliff, Hamilton turned and saw three elk behind her. She knew this had special significance and meaning. Overcome with awe, she felt peaceful and resolute. Little did she know that these feelings would help her through a difficult period in her life, one that would soon come to pass.

Tracking Down an Elusive Illness

Hamilton took this early summer vacation to celebrate her daughter's graduation from college. While backpacking and hiking on their "road trip," Hamilton often had to stop and rest. "I felt so winded, which is unusual for me," she says, "but I attributed it to higher altitudes and middle age." Their trip consisted of driving, hiking and camping in the Grand Canyon, Rocky Mountain National Park, Mount Rushmore and other places throughout Texas and California. "I thought maybe we just tried to do too much in a short time," recalls Hamilton.

After returning from the trip, her symptoms continued. In addition, she developed a number of lesions that were characteristic of bruises and blisters. She also began to run fevers, experience chills and developed blurry vision in her left eye. "I just felt unwell and lacked energy. Sometimes I'd feel somewhat close to normal during the day and then run a high fever again at night," explains Hamilton.

"My doctors thought maybe I picked up Rocky Mountain fever or some type of insect-borne illness while on vacation," she says. "Things weren't that bad, but I just didn't feel right." The fevers spiked night and left for the day, so often Hamilton would just muddle through the day and see what nighttime would bring. "But the fevers always returned," she says. "Finally, I went to the emergency room while I was running a 104-degree fever. I followed up with my family doctor several times before receiving the worst news possible," she says.

Facing Cancer and the Unknown

In June 2000, Hamilton was diagnosed with stage 4 peripheral T-cell lymphoma. And, yes, the illness is as daunting as the name. The disease is complicated and so is its treatment.

"Wendy's form of non-Hodgkin's lymphoma was quite advanced and very aggressive," says Ivana Micallef, M.D., a hematologist at Mayo Clinic in Rochester. "Cells are classified based on the role they play in the immune system. B-cells make antibodies and the T-cells function in cell-mediated immunity. Non-Hodgkin's lymphomas are classified based on the cells from which they are derived; 80 percent are B-cell lymphomas and 20 percent are T-cell lymphomas."

With non-Hodgkin's lymphoma, the T-cell type is more aggressive and associated with a poorer prognosis or outcome. "And while Wendy's type was an aggressive form of the disease, her symptoms were not classic or typical," notes Dr. Micallef. "Most people have swollen lymph glands and telltale blood results. Wendy didn't," she notes.

After her diagnosis, Hamilton began an up-and-down journey of treatment, apparent recovery and then relapse. "She went through several chemotherapy regimens," says Dr. Micallef, "and would appear to be getting better, but then new lesions would appear and her symptoms would return."

For Hamilton, her time on this earth seemed to be running out. She was not responding to chemotherapy and with each passing regimen, her hope was dwindling. With lymphoma, the disease needs to be in remission to consider a stem cell transplant, her best hope for survival. "After the first unsuccessful treatment, we went to what we call salvage or second-line chemo," notes Dr. Micallef, "and this didn't appear to be effective. Then, during the second type of salvage chemotherapy, Wendy slowly started improving, with no progression of her skin lesions. We were able to get her to a situation in which we could harvest some of her stem cells and consider an autologous bone marrow transplant."

A Multifaceted Treatment

For Hamilton, an autologous bone marrow transplant was the best bet against her disease. "Autologous means a patient's own stem cells are harvested and then reinjected after the patient receives high-dose chemotherapy and radiotherapy," explains Dr. Micallef. "Other options include allogeneic transplants from family members or an unrelated donor from the national registry," explains Dr. Micallef. Unfortunately, the chances of finding a match — even within families — are low. And then, the chances of rejection and complications are much higher than with autologous transplants. "For someone in a remission from non-Hodgkin's lymphoma, our preference is an autologous stem cell or bone marrow transplant," says Dr. Micallef.

"The transplant treatment involves harvesting or aspirating bone marrow," explains Dr. Micallef, "and then the cells are frozen using a cryopreservation technique."

While the cells are preserved, the patient undergoes transplant conditioning, which includes a combination of chemotherapy, and sometimes radiation, prior to the stem cell transplant.

Once the patient is ready, the treated cells are reinjected into the body to repopulate the bone marrow. "It's much like a blood transfusion," says Dr. Micallef. It takes only a short time to do the transplant, but the conditioning therapy is often what gives rise to complications.

Hamilton was monitored daily for several months following her transplant, until her blood counts recovered. "On day 100 following the transplant, we test the patient's bone marrow and perform a computed tomography (CT) body scan," says Dr. Micallef. For Hamilton, there was no sign of the disease on day 100 or anytime since. "We continued to see Wendy every three months for three years, which has now passed," notes Dr. Micallef, "and she only needs follow-up every six months for the next two years."

Giving Back

"I am so fortunate to be here today," says Hamilton. "Research and modern medicine are so fascinating and awesome, that I can't pretend to understand. However, I do know that it's only because of advances in treatment and God's grace, I'm here to appreciate the people who dedicate their time and talents to medicine."

Hamilton turned her overwhelming sense of appreciation into action. She went through an allied health sciences professional training program and now works as a lab technician in Mayo Clinic's phlebotomy lab. And, she volunteers with the Leukemia & Lymphoma Society, helping people whose lives are affected by different types of blood cancers.

"I was very blessed to be able to carry a white balloon in the society's walk around Lake Phalen in Minneapolis," says Hamilton. "A while balloon indicates I'm a cancer survivor."

Hamilton will never forget all the people who were involved in her multifaceted treatment and recovery. "I'm giving back in honor of all the people who gave me a second chance at life. I want to instill in others the same type of hope and happiness I have."

Once again, she makes an entry in her journal:

"Thank you God for the marvels of modern medicine and the people who so unselfishly dedicate their lives to health-care practice and research."