Skip to cookie consent Skip to main content

Specialized Expertise Transformed a Critical Setback From Peripheral T-cell Lymphoma Into Hope

Contributors: Salvia Jain, MD; Steven McAfee, MD
5 minute read
Jennifer (center) at home with her family.

When Jennifer Brennan's initial treatment for peripheral T-cell lymphoma—a rare and aggressive blood cancer—failed, the impact could have been devastating. Instead, because she was under the care of a highly specialized expert in her condition, it became an opportunity to access cutting-edge treatment not widely available.

Jen, now 53, completed a complex treatment journey, including a stem cell transplant, that ultimately saved her life. Today, she's cancer-free and living proof of the power of specialized care.

"I almost feel better than I did before I got diagnosed, which seems weird," she said. "But I do feel really good 99% of the time." 

A shocking diagnosis

After noticing a lump in her neck, Jen scheduled an appointment with her primary care doctor. Her doctor found several enlarged lymph nodes in her neck.

Months of testing led to a diagnosis of peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS). It is the most common subtype of peripheral T-cell lymphoma.

"I was healthy and had always taken care of myself, so the diagnosis was definitely a shock," Jen said. "I didn't feel sick. In fact, I was running right up the day I found out."

Her first consultation with a lymphoma specialist left her feeling uneasy, as the doctor had limited experience treating peripheral T-cell lymphoma. Determined to find the best possible care, Jen sought out Salvia Jain, MD, a hematologist and medical oncologist at Massachusetts General Hospital, a founding member of Mass General Brigham.

A national expert on T-cell lymphomas

Dr. Jain is one of the country's top experts on T-cell lymphomas. At Mass General, she leads research that aims to understand the biology of these diseases and develop more effective therapies. She is also the founder of the PETAL Consortium. This global network of investigators collaborates to improve outcomes for patients with T-cell lymphomas by accelerating scientific breakthroughs to early-phase clinical trials.

Jennifer during treatment with her family.

"It was clear she knew exactly what to do," Jen said. "I felt complete confidence in her." 

Jen's treatment started with chemotherapy to remove all signs of cancer from her body (remission). At the time, the plan was to proceed with autologous stem cell transplantation for consolidation. In this procedure, the patient's own stem cells are collected, stored, and later infused back into the body to restore the bone marrow's ability to make healthy blood cells. 

Although she responded well to the first few rounds of chemotherapy, the end-of-treatment scan showed the cancer had returned. This could have been a crushing blow. Fortunately, Dr. Jain had an alternate plan, one that would not have been available at many hospitals.  

From cutting-edge research to lifesaving care

The new plan was bold: an allogeneic stem cell transplant, where donor stem cells would replace Jen's immune system to better recognize and fight the cancer. First, however, Jen would need to achieve a remission that was, in Dr. Jain's words, "deep and durable."

To achieve this, Dr. Jain turned to a cutting-edge cancer treatment strategy that she had previously studied in a clinical trial testing. It featured a novel combination therapy of two drugs to treat patients with T-cell lymphomas.

"At Mass General, we are leading research that gives us access to novel information other doctors might not have," Dr. Jain said. "This sometimes allows us to offer patients treatment options that other hospitals can't offer and, in many instances, years ahead of their approval by federal agencies and national committees."

The combination therapy got Jen back into remission. Now, Steven McAfee, MD, clinical director of Mass General's Bone Marrow Transplant Program, would take over her care.

Deep experience with stem cell transplants

Dr. McAfee has been performing stem cell transplants for three decades. He explained that the goal of Jen's allogeneic stem cell transplant was to replace her immune system with donor stem cells capable of recognizing her lymphoma.

"Jen's immune system wasn't recognizing her lymphoma as foreign, which allowed it to grow," he said. "The transplant aimed to introduce a new immune system that would identify and destroy the cancer cells."

The search for a donor began when Jen started combination therapy. The team successfully identified two matches from anonymous donors.

Prior to the transplant, Jen underwent seven days of chemotherapy at Mass General to remove her faulty stem cells. Then, the donated stem cells were infused intravenously. "I didn't feel anything," she said. "They monitor you the entire time to make sure there's no reaction."

Three more days of chemotherapy followed the transplant. This round was more physically challenging for Jen. In addition to extreme fatigue, she had bone pain associated with her bone marrow creating white blood cells.

"The ability to keep getting up off the mat makes a huge difference," Dr. McAfee said. "Jen's determination and ability to keep fighting gave her the best chance of recovery."

'Nowhere else I'd rather be'

Jennifer in the hospital surrounded by family.

Jen stayed at Mass General for about two weeks post-transplant as her body went through the process of accepting the donated stem cells. Upon returning home, she had "the lowest energy you could possibly imagine." But she was not in pain.

For the first few months after the transplant, Jen had few restrictions. Slowly, she regained her strength, walking up to five miles a day by the fourth month.

Today, one year later, Jen's scans show no signs of cancer. 

"With an aggressive lymphoma like Jen's, the first two years are critical," Dr. McAfee said. "After that, the odds are very much in the patient's favor that their disease will never come back."  

Jen is looking forward to an upcoming family trip to see a daughter who is studying in Copenhagen, Denmark. It will represent a full-circle moment, as the family had been planning to visit Europe before she was diagnosed with cancer. 

"I feel very fortunate that I had access to Mass General and that I had Dr. Jain and Dr. McAfee as my doctors," she said. "I can't say enough about the care I've received. There's nowhere else I'd rather be."

Learn more about research-driven cancer care at Mass General Brigham
Salvia Jain, MD

Contributor

Salvia Jain, MD
Hematologist and Medical Oncologist
Steven McAfee, MD

Contributor

Steven McAfee, MD
Clinical Director, Bone Marrow Transplant Program

We're One Against Cancer

At Mass General Brigham, we harness the collective strength of our healthcare system to provide research-driven excellence in cancer care for the patients and communities we serve.

Learn more