Active Lifestyles February 2020
A new generation continues Bemis family tradition at Bemis Tupman Chiropractic
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2 February 2020
Active Lifestyles
Chelsea Steer Au.D.
Steven Steer Au.D.
Timothy Fick AAS-HIS, BC-HIS
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3511 College Ave. Alton, IL 62002
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Active Lifestyles Staff
What’s inside 3 Cover story:
9 ‘Older soul’ takes helm at AM Rehab & Therapy
Couple carry on family tradition
10 Rock Steady 6 ‘Dear Dietitian’ answers your health Boxing Alton continues growth questions 7 No excuse good enough to avoid colonoscopy
12 Mutations in donors’ stem cells may cause problems
8 Eunice Smith Home re-named Alton Memorial Rehabilitation & Therapy
13 Vaccinations adults get them, too
ACTIVE LIFESTYLES PUBLISHER Denise VonderHaar dvonderhaar@edwpub.net (618) 463-2500 ACTIVE LIFESTYLES ADVERTISING DIRECTOR Carole Fredeking carole.fredeking@hearst.com (618) 463-2500 ACTIVE LIFESTYLES EDITOR-IN-CHIEF Jill Moon jill.moon@hearst.com (618) 208-6448 ACTIVE LIFESTYLES COORDINATOR Regina Harbison rharbison@thetelegraph.com (618) 208-6433
INSIDE
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New name, new logo, same quality service
Rock Steady Boxing Alton continues growth
February 2020 3
ON THE COVER: Dr. Frank C. Bemis, left, his daughter, Dr. Kristina E. Bemis Tupman, right, and her husband, Dr. Stephan P. Tupman, standing, at Bemis Tupman Chiropractic, 4105 Humbert Road suite 101, Alton. Dr. Bemis turned over the practice, formerly named Dr. Frank C. Bemis & Associates Chiropractors, in December to the couple, married in 2017. Dr. Bemis began practicing in Alton in 1966 and opened his own business in 1986.
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John Badman | Active Lifestyles
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John Badman | Active Lifestyles
Dr. Kristina E. Bemis Tupman, right, talks with front desk coordinator Emily Medford at Bemis Tupman Chiropractic, 4105 Humbert Road suite 101, in Alton. Bemis Tupman is the ninth Bemis, fourth generation and first female in the family to carry on the chiropractic legacy.
Chiropractic couple carry on family tradition First female Bemis chiropractor at helm of father’s former practice By Jill Moon
4 February 2020
Active Lifestyles
jill.moon@hearst.com
ALTON — In the generations of a historic line of Bemis family chiropractors, for the first time a Bemis daughter has taken the helm of one of the Riverbend’s Bemis practices, that of Dr. Frank C. Bemis, who now works part time. In passing the torch to his daughter, Dr. Kristina E.
Bemis Tupman, she is joined by her husband, Dr. Stephen P. Tupman, at Bemis Tupman Chiropractic, formerly Dr. Frank C. Bemis & Associates Chiropractors, at 4105 Humbert Road suite 101, Alton. The Alton couple married in 2017 and became the owners of Bemis Tupman Chiropractic this past December. Drs. Tupman both are 2015 graduates of Palmer
College of Chiropractic, in Davenport, Iowa, where Dr. Bemis Tupman followed in her father’s footsteps, as he did his father’s and grandfather’s. Dr. Bemis Tupman did so not only by becoming a doctor of chiropractic, but she also graduated from the same college as they did. Her great grandfather, Dr. Francis Edward Bemis, a chiropractic pioneer, entered the field of chiropractic at its veritable infancy. He obtained the first practitioner license in the
state of Vermont and then then practiced in New York for 52 years. His great granddaughter is the ninth Bemis, fourth generation and first female in the family to carry on the chiropractic legacy established when Dr. Bemis graduated from Palmer more than 100 years ago. The native New Englander graduated in 1915, returning East, from where Dr. Tupman also comes from Concord, New Hampshire. The next Bemis to graduate from Palmer was Dr.
Bemis Tupman’s grandfather, Frank E. Bemis. He and his wife, Dorothy, settled in Alton when their son, Frank C. Bemis, was just 3 years old. Likewise, Frank and his younger brother, Gerald, also graduated from Palmer and both returned to Alton to join their father’s practice. Today there are seven Bemis chiropractors who practice in Alton. Dr. Frank C. Bemis’ youngest child explained to The Telegraph how she shared her decision to join the family practice. “I sat my parents down when I was seven years old, and told them I was going far away for college,” Dr. Bemis Tupman said. “I said I’d be a dancer and then come home and be a chiropractor.” And that’s what she did. Dance has been a part of Dr. Bemis Tupman’s life almost as long as chiropractic. She began dance lessons when she was 3; went on a two-week tour, when she was 14, to different venues, including Disney World; became part of a touring professional troupe in high school; and, performed at the Pro Bowl in 2000, along with 98 Degrees. She made dance a permanent part of her life through education and an early career. She still keeps one foot on the stage participating in Alton Little Theater productions. In 2007, Dr. Bemis Tupman received a bachelor’s
Meet Dr. Stephen P. Tupman
De. Stephen P. Tupman
Dr. Kristina E. Bemis Tupman
February 2020 5
Tupman Chiropractic’s current location July Fourth weekend of 1986. Dr. Bemis Tupman chose to attend Palmer College of Chiropractic not only because of her family history there, but because that is where chiropractic started, she explained. “The person who discovered chiropractic, D.D. Palmer, restored a man’s hearing by adjusting him in 1895,” she explained, “and the Palmer School of Chiropractic was started just two years later, in 1897.” Bemis Tupman Chiropractic’s care is family-based, treating a range of ages, from infants to those in their 90s. The variety of techniques that the Bemis Tupman Chiropractic team uses are suitable for many different conditions. These techniques include both manual and instrument-based adjusting and are gentle and specific. Bemis Tupman Chiroprac-
Active Lifestyles
in dance with a minor in natural sciences from Los Angeles’ Loyola Marymount University. Eventually, she knew, she’d join the family ranks as a chiropractor, but she had one more level to reach in dance. She landed her first professional job in L.A. and continued her dance career in St. Louis when she moved back home to Alton in 2008, continuing this career until she moved in 2012 to attend Palmer. And then, eventually, she did become a chiropractor. She graduated from Palmer exactly 100 years after her great grandfather; 74 years after her grandfather; and, 50 years after her father, who was the commencement speaker at his daughter’s Palmer graduation in 2015. Dr. Bemis Tupman began practicing at her dad’s office the same year. He began practicing in in Alton in 1966 and opened his own business at Bemis
Dr. Stephen P. Tupman, born and raised in Concord, New Hampshire, studied biology at the University of Massachusetts Lowell before starting his chiropractic journey to Palmer College of Chiropractic in Davenport, Iowa, from where he graduated in 2015. As a chiropractic student, he worked in the college’s anatomy laboratory for seven of his 10 trimesters in order to further expand his knowledge and understanding of human anatomy. He completed more than 150 extracurricular hours of study to earn Certified Chiropractic Extremity Practitioner Certification (CCEP). Dr. Tupman spent his tenth Palmer trimester as an intern at Dr. Frank C. Bemis & Associates. After graduation, he practiced in Missouri for more than one year until he joined the Bemis team in 2017 as a full-time chiropractor.
tic also is the only Alton practice using the ProAdjuster, a sophisticated type of technology that allows for gentle, safe manipulation without any sudden movements. Dr. Bemis Tupman’s patients include some of her father’s former longtime patients. As it turned out, her knowledge of dance, as well now of Pilates, has helped her in practicing chiropractic. She did her undergraduate senior thesis about Pilates, earned Pilates teaching certification and, while working in L.A., gained more hands-on Pilates knowledge. “Pilates and dance complemented each other,” she noted, “and, likewise, to chiropractic.” Dr. Bemis Tupman also is certified in the Webster technique, a specific sacral chiropractic adjustment to help facilitate a pregnant patient’s pelvic alignment and nerve system function. This in turn balances pelvic muscles and ligaments, reduces torsion to the uterus and gives the greatest potential for optimal fetal positioning. The Webster technique is particularly helpful to pre- and post-natal women, but can be used on all weight-bearing individuals for various symptoms, including low back pain and sciatic neuralgia. Today, Bemis is a respected name in the world of chiropractic academia. And, on June 18, 2019, Drs. Tupman welcomed their first child, Paris Elayne Tupman, another Bemis female who might become a chiropractor, eventually. Follow Bemis Tupman Chiropractic on Facebook, visit www.bemischiropractic.com or call 618-463-1600 for more information and business hours.
Dear Dietitian Rated best diets share common thread: more plant foods, less meat Dear Readers, Now that we are getting settled into the new year, many of us are working on getting healthier. There is so much information about diets, sometimes it’s hard to know what is really good for you. U.S. News rated 35 diets and coming in first for overall health — not just weight loss — was the Mediterranean Diet. The Flexitarian and Dietary Approaches to Stop Hypertension (DASH) diets tied for second place. A panel of nutrition experts ranked the diets based on seven categories: how easy it is to follow, its ability to produce short-term and long-term weight loss, its nutritional completeness, its safety and
its potential for preventing and managing diabetes and heart disease. Most of us have heard of the Mediterranean diet, but it was American scientist Ancel Keys who first correlated the diet with health benefits. It is a plant-based diet rich in fruits, vegetables, whole grains, nuts and olive oil. Moderate amounts of fish, poultry and dairy serve as protein sources, with red meat eaten no more than once a week. Red wine is allowed in moderation, as is caffeine. The DASH diet emphasizes whole grains, fruits and vegetables. It is low to moderate in fat and allows 6 ounces of meat a day. The DASH diet reduces salt to 1 teaspoon
a day, or 2,300 mg. Keep in grains. For example, a whole mind this includes the amount wheat pasta with sun-dried of salt already in food before tomatoes, olive oil, herbs and one uses the salt shaker. Stud- seasonings, more veggies, and ies have shown that it sprinkled with fresh improves high blood Parmesan cheese makes pressure in as little as a delicious entrée. Fresh two weeks. Caffeine and fruit with a touch of alcohol are permitted in whipped cream will satmoderate amounts. isfy your sweet tooth. Flexitarian combines It takes conscious the words flexible and effort and planning McCrate vegetarian. The term to change your eating was coined by dietitian habits. When making a Dawn Jackson Blatner, who lifestyle change, give yourself published the first book on at least 4 to 6 weeks to get flexitarianism. It basically is accustomed to it. If you “fall a plant-based diet that allows off the horse,” get back in the limited amounts of fish and saddle. That’s the only way meat. Alcohol and caffeine are you’ll learn to ride. not restricted, but it’s wise to Until, next time, be healthy! use them in moderation. This Dear Dietitian diet is easy to follow and, as Leanne McCrate, RDN, LD, the name implies, its ease lies CNSC is an award-winning in its flexibility. dietitian based in Missouri. Her mission is to educate consumers The common thread on sound, science-based nutrition. throughout these diets is a Do you have a nutrition question? goal of eating more plant Email her at deardietitian411@ foods and less meat. Try gmail.com. Dear Dietitian does not to plan your meals around endorse any products, health profruits, vegetables and whole grams, or diet plans.
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Active Lifestyles
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No excuse good enough to avoid colonoscopy OSF HealthCare Saint Anthony’s Health Center
Special to Active Lifestyles
liters of a foul-tasting concoction, which prompted frequent bowel movements. While clearing your bowels remains necessary, today’s prescriptions are less voluminous and taste better. ‘Best nap you’ll ever get’ Linda’s experience has made her a warrior of sorts on the front lines of screening advocacy. Most recently, she has been lecturing her younger brother, who is 48 and resisting with some of the same excuses Linda once used. “Silly things,” she calls those excuses now. “I thought it would be uncomfortable, but it wasn’t,” Linda said. “I tell people it was the best nap you’ll ever get. Take it. “Take the day. It’s OK. I’m helping my brother realize he has to take that day now. It’s OK to take a day for ourselves. We’re all worth that one day.” For more information, contact OSF HealthCare Saint Anthony’s Health Center.
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in people under 50, a fact that is driving the medical community toward recommending screens begin at 45. And because it’s a key risk factor, a history of colorectal cancer in your family should make you get a colonoscopy as young as 40, Dr. Quyyum said. You can take preventive measures such as focusing on an active lifestyle and a healthy diet high in fruit and vegetables. Dr. Quyyum said taking 81 mg of aspirin each day also helps decrease the risk of colorectal cancer. Then, there’s the colonoscopy. “It’s a very quick procedure,” Dr. Quyyum said. “You are sedated. Complications and risks are low. The part people really hate is the day-before bowel prep, but that has improved a lot.” Only a few years ago, preparation the day and night before the procedure included drinking four
February 2020
“Colon cancers develop as a polyp, and over a decade they mutate and become cancer. So if you find polyps and take them out, you actually prevent colon cancer,” said Asif Quyyum, MD, cancer surgeon at OSF HealthCare Saint Francis Medical Center in Peoria, Illinois. “Prevention is key. First prevention, then early detection. “Linda got lucky because we found the cancer early on,” Dr. Quyyum continued. “The vast majority of patients need surgery instead of a colonoscopy to get it out, and a good portion need chemotherapy. You can avoid those things by getting detected early.” Bowel prep routine improves More than 50,000 Americans each year die from colorectal cancers, which rank behind only lung and bronchus among cancer fatalities. Moreover, rates of colorectal cancers are rising
Active Lifestyles
ALTON — As she approached her 50th birthday, Linda Connolly heard the lectures and saw the warnings: Get a colonoscopy. But Linda ignored the commercials, news stories and mailings and blew right past the milestone. She was healthy and active. She didn’t have time to take off a day from work. And what she had heard about the preparation process left a lot to be desired. Now? “I should have taken a day off from work five years ago, and maybe I wouldn’t be here now,” Linda said. At 55 years old, she finally relented and scheduled a colonoscopy. She got the results on February 14. “Being Valentine’s Day, I asked my husband what he was doing. He said he had meetings,” Linda said. “I said, ‘Well, I have cancer. Why don’t you take the day off and talk to me?’ So he did.’” Colonoscopy helps prevent, detect cancer The good news is that Linda’s cancer was confined to one polyp and was Stage 0-1. The polyp was removed during the colonoscopy, and Linda worked with her OSF HealthCare cancer care team to build an aggressive plan that includes frequent testing to help ensure longterm survival. But Linda wonders how things might be different if she had undergone the colonoscopy half a dozen years ago. Could she have avoided her current treatment plan and the emotional concerns that accompany a cancer diagnosis?
New name, new logo, same quality service Eunice Smith Home re-named Alton Memorial Rehabilitation & Therapy Alton Memorial Hospital Special to Active Lifestyles
ALTON — Eunice Smith Home, the skilled nursing and rehabilitation community that has been serving the senior communities of Alton, Godfrey and the Riverbend area for 53 years, officially became known as Alton Memorial Rehabilitation & Therapy in December. “We are committed to keeping the Eunice Smith legacy and building upon the high standards of excellence this community has provided,” said Daniel Vogel, administrator of Alton Memorial Rehabilitation & Therapy. “We believe this legacy can only be enhanced
by the numerous advantages of aligning with Alton Memorial Hospital and its reputation for quality, conscientious care for seniors living in the Riverbend area and their families.” Currently rated as a five-star community by the Centers for Medicare and Medicaid Services (CMS) in the area of quality measures, the rehabilitation, skilled nursing and long-term care services at Alton Memorial Rehabilitation & Therapy are provided by the experienced professionals from Bethesda Health Group, which manages the community per an agreement with community owner BJC HealthCare.
WARNING
For Active Lifestyles
Daniel Vogel, administrator, and Hazel Morgan, referral coordinator, watch as the new Alton Memorial Rehabilitation & Therapy sign is installed Dec. 18 outside the formerly named Eunice Smith Home, in Alton.
In the coming months, Alton Memorial Rehabilitation & Therapy will hold an open house, and at the time will unveil areas of the community that honor the history and reflect the essence of “Miss Eunice,” including a Healing Garden.
Side effects of hearing wellness may lead to improved cognitive function
HEALTHY LIVING STARTS WITH HEALTHY HEARING
8 February 2020
Active Lifestyles
“When you don’t hear well, your brain has to devote extra energy to understanding sound, leaving less brainpower for thinking and memory. Treating your hearing loss frees up those resources, improving your brainpower.” — Dr. T.K. Parthasarathy, President and Former SIUE Professor of Audiology
For more information about the services offered at Alton Memorial Rehabilitation & Therapy, please contact Hazel Morgan, referral coordinator, at 618-463-7336 or hlmorgan@bethesdahealth. org, or go to www.Bethesda Health.org.
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‘Older soul,’ age 26, takes helm at AMRT Alton Memorial Hospital Special to Active Lifestyles
ALTON — Daniel Vogel is out to improve the image of millennials, at least to those of more “seasoned” generations. Vogel, 26, is the new administrator of Alton Memorial Rehabilitation & Therapy (AMRT), which is the new name for Eunice Smith Home. His age puts him a few decades behind most of the patients and residents at AMRT, but Vogel is quick to alleviate any anxiety about that. “I’ve always had an older soul,” he says with a smile. “Some millennials have gained that reputation for maybe not having so much respect for our older population. But that’s not me. I love being around our residents. In addition to seeing the progress they’re making, just hearing their life stories is wonderful.” Vogel is a St. Louis native, having graduated from Rockwood Summit High School, and earning his Master of Health Administration in 2018 at the University of Missouri-Co-
lumbia. He has experience as an EMT, as well as managing Kirkwood Water Park for several summers during college. In addition, he worked in the acute care setting with pharmacy and interning for a hospital CEO. “I have always had an interest in long-term care because both of my grandmothers went through it all, some good and some not so good,” Vogel said. “I think I really have a heart for it. I rotated through all of Bethesda Health Group’s skilled health communities, and now I wear a lot of hats here. I’m certainly still learning the position, but it helps to involved with every part of it. It’s good to see so many of our residents out and about, and we have such a friendly staff.” Vogel says that 80% of AMRT residents are in for rehab, a shift from the old days of nursing homes being a place to go only for long-term residency. “But that means they have a goal to progress and get better so they can get back to being independent,” he said. “And it’s so rewarding to see them accomplish that.”
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Rock Steady Boxing Alton continues growth helping those with PD Senior Services Plus
10 February 2020
Active Lifestyles
Special to Active Lifestyles
ALTON — When Senior Services Plus (SSP) Inc. became affiliated to Rock Steady Boxing, a program known to help people with Parkinson’s disease (PD), began humbly in 2015, adding to an array of services already offered by the nonprofit senior center. Rock Steady Boxing (RSB) began with only two members and two SSP classes a week that took place in a group fitness room, located in a repurposed elementary school. The equipment was scarce, comprised of a few used 50-pound bags, some worn gloves, folding chairs, a beach ball and swimming pool noodles. “RSB is great exercise for people with PD,” boxer Don Joehl, 86, said. “There is tremendous benefit to the class, but remember to fight every day.” But the most creative boxing equipment used then was a row of foam golf balls hanging from the ceiling, whimsically nicknamed “cat toys.” These cost effective, moving targets were soft, lightweight enough to be struck with bare hands and bounced around a lot, challenging the boxers to coordinate their strikes. The “cat toys,” as the class dubbed them, and keeping the beach ball flying in the air, became class members’ favorite drills. And with that kind of continued creativity, faithful membership who swore by the efficacy of the class and a driven staff, the Rock Steady program began to grow. Then in early 2017, the program was in limbo when SSP’s only certified instructors took employment elsewhere. SSP Chief Executive Officer John Becker, in his determina-
Photos for Active Lifestyles
Rock Steady Boxing (RSB) Alton Assistant Coach Mark VandeHey, left, works with RSB class member, boxer Don Joehl, 86, at SSP Wellness.
tion to keep the program running, commissioned a previous assistant, Dustin Heiser, to earn certification in Indianapolis and become the program’s new head coach. Now, Heiser has taught Rock Steady Boxing classes four times per week for more than three years — in addition to being the SSP Wellness full-time wellness coordinator. With a wide range of experience in training people of different ages and levels of fitness, Heiser still attests that coaching Rock Steady Boxing is always the best time of the day. “Rock Steady Boxing is my favorite hour of my day,” said
Heiser, RSB head coach and SSP wellness coordinator. “I have seen people, who start out as strangers, come together like family and work hard together to the maximum of their capabilities. “I’ve never been around a group that is so inspiring.” Joehl’s wife, Marilyn, agreed. “I notice the positive effects when (Don) attends,” she said, “especially in his attitude. “The class has a huge amount of camaraderie, socialization and community for caregivers and boxers,” said Marilyn Joehl, who’s an RSB Alton cornerman. “You’re not alone!” In January of last year Rock
Steady Boxing Alton and the SSP Wellness Center improved immensely with the all-new construction of a state-of-theart fitness center. In stark contrast to the old elementary school classroom, the new facility is 10,000 square feet with more than 100 new pieces of fitness equipment, including an indoor walking track, free weights, pin-loaded machines, cardio equipment and a 2,200-square-foot group fitness classroom. The group fitness classroom was equipped with brand new TITLE boxing equipment especially for the Rock Steady program. The equipment includes 130-pound Thai punching bags, adjustable speed bags, double end bags, weighted gloves, agility ladders, hurdles and much more. The classroom also stores cardio equipment, such as new Keiser spin bikes, which boxers use to warm up or for intervals during workouts. A Century Body Opponent Bag, called BOB, that sports a Rock Steady Alton T-shirt, provides boxers with a bag for targeted strikes. In addition to the Rock Steady classes, members meet up for group cardio sessions or strength training sessions. Some of the boxers plan together and take part in some of SSP’s other group fitness classes offered in the wellness center. Along with Rock Steady Boxing, more than 50 other group fitness classes take place each week at SSP Wellness. Those classes include tai chi, yoga, Zumba, spinning, kettlebell, chair exercise, circuit training, weekend boot camp and more. Rock Steady Alton now offers two different levels of classes four times per week, including two mixed-level classes per month. The pair of mixed-level classes are
designed as a class game day, allowing all the class levels to come together and cultivate team camaraderie. Heiser and assistant coach Mark VandeHey lead every Rock Steady Boxing class. The program has served approximately 50 Rock Steady boxers since it began in 2015. As the new year started, the class sizes hovered around 20 participants per two coaches in each class. The SSP membership brings primarily people with levels three and four Parkinson’s disease to Rock Steady Boxing Alton, but the program welcomes all members at any level of Parkinson’s disease. “The two original members who started with the class in 2015, still participate in the program to this day,” Heiser said. SSP, located in Alton, is a nonprofit social service agency that provides an array of services and support for the community and area senior citizens. SSP has offered
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Rock Steady Boxing Alton all-level class at SSP Wellness. Senior Services Plus (SSP) Inc. is partnered with United Way.
opportunities and resources to people as they age for more than 45 years. Services include SSP Wellness Center and Meals On Wheels program, as well as travel, transportation and non-medical in-home care services. SSP is a leader in aging services in the community and region. It offers a mix of sup-
port and services, and works to make its programs affordable. The fee for service programs and revenue-generating programs benefit SSP’s mission services. As a locally owned nonprofit organization, partnered with United Way, SSP is a part of the community and wants to give back to people and keep the community
strong. Contact Senior Services Plus at 618-465-3298. Senior Services Plus is located at 2603 N. Rodgers Ave., Alton, Illinois.
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Mutations in donors’ stem cells may cause problems for cancer patients Heart problems, graft-versus-host disease are concerns Special to Active Lifestyles
12 February 2020
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ST. LOUIS — A stem cell transplant — also called a bone marrow transplant — is a common treatment for blood cancers, such as acute myeloid leukemia (AML). Such treatment can cure blood cancers but also can lead to life-threatening complications, including heart problems and graft-versus-host disease, in which new immune cells from the donor attack a patient’s healthy tissues. A new study from Washington University School of Medicine in St. Louis suggests that extremely rare, harmful genetic mutations present in healthy donors’ stem cells — though not causing health problems in the donors — may be passed on to cancer patients receiving stem cell trans-
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plants. The intense chemo and radiation therapy prior to transplant and the immunosuppression given after, allow cells with these rare mutations the opportunity to quickly replicate, potentially creating health problems for the patients who receive them, suggests the research, published Jan. 15 in the journal Science Translational Medicine. Among the concerns are heart damage, graft-versus-host disease and possible new leukemias. The study, involving samples from patients with AML and their stem cell donors, suggests such rare, harmful mutations are present in surprisingly young donors and can cause problems for recipients even if the mutations are so rare as to be undetectable in the donor by typical genome sequencing techniques.
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The research opens the door to a larger study that will investigate these rare mutations in many more healthy donors, potentially leading to ways to prevent or mitigate the health effects of such genetic errors in patients receiving stem cell transplants. “There have been suspicions that genetic errors in donor stem cells may be causing problems in cancer patients, but until now we didn’t have a way to identify them because they are so rare,” said senior author Dr. Todd E. Druley, an associate professor of pediatrics. “This study raises concerns that even young, healthy donors’ blood stem cells may have harmful mutations and provides strong evidence that we need to explore the potential effects of these mutations further.” “Transplant physicians tend to seek younger donors because we assume this will lead to fewer complications,” said co-author Dr. Sima T. Bhatt, an assistant professor of pediatrics who treats pediatric patients with blood cancers at Siteman Kids at St. Louis Children’s Hospital and Washington University School of Medicine. “But we now see evidence that even young and healthy donors can have mutations that will have consequences for our patients. We need to understand what those consequences are if we are to find ways to modify them.” The study analyzed bone marrow from 25 adult patients with AML whose samples had been stored in a repository at Washington University. Samples from their healthy matched donors, who were unrelated to the patients, also were sequenced. The donors’ samples were provided by the Center for International Blood and Marrow Transplant Research in Milwaukee, Wisconsin. The 25 AML patients were chosen because they each had
had samples banked at four separate times: before the transplant, at 30 days post-transplant, at 100 days post-transplant, and one year post-transplant. Druley co-invented a technique called error-corrected sequencing, to identify extremely rare DNA mutations that would be missed by conventional genome sequencing. Typical next-generation sequencing techniques can correctly identify a mutation that is present in one in 100 cells. The new method, which can distinguish between true mutations and mistakes introduced by the sequencing machine, allows the researchers to find true mutations that are extremely rare — those present in as few as one in 10,000 cells. The healthy donors ranged in age from 20 to 58, with an average age of 26. The researchers sequenced 80 genes known to be associated with AML, and they identified at least one harmful genetic mutation in 11 of the 25 donors, or 44%. They further showed that 84% of all the various mutations identified in the donors’ samples were potentially harmful, and that 100% of the harmful mutations present in the donors later were found in the recipients. These harmful mutations also persisted over time, and many increased in frequency. Such data suggest the harmful mutations from the donor confer a survival advantage to the cells that harbor them. “We didn’t expect this many young, healthy donors to have these types of mutations,” Druley said. “We also didn’t expect 100% of the harmful mutations to be engrafted into the recipients. That was striking.” According to the researchers, the study raises questions about the origins of some of the wellknown side effects of stem cell transplantation. “We see a trend between mutations from the donor that persist over time and the development of chronic graft-versus-host
disease,” said first author Wing Hing Wong, a doctoral student in Druley’s lab. “We plan to examine this more closely in a larger study.” Though the study was not large enough to establish a causal link, the researchers found that 75% of the patients who received at least one harmful mutation in the 80 genes that persisted over time developed chronic graft-versus-host disease. Among patients who did not receive mutations in the 80 genes, about 50% developed the condition. Because the study was small, this difference was not statistically significant, but it is evidence that the association should be studied more closely. In general, about one half of all patients who receive a stem cell transplant go on to develop some form of graft-versus-host disease. The most common mutation seen in the donors and the cancer patients studied is in a gene associated with heart disease. Healthy people with mutations in this gene are at higher risk of heart attack due to plaque buildup in the arteries. “We know that cardiac dysfunction is a major complication after a bone marrow transplant, but it’s always been attributed to toxicity from radiation or chemotherapy,” Druley said. “It’s never been linked to mutations in the blood-forming cells. We can’t make this claim definitively,
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A new study from Washington University School of Medicine in St. Louis suggests that bone marrow — or blood stem cells — from healthy donors can harbor extremely rare mutations that can cause health problems for the cancer patients who receive them. Such stem cell transplants are important for treating blood cancers, including acute myeloid leukemia. In the healthy bone marrow pictured, mature red blood cells are shown as small brownish-pink discs; red blood cells that are still developing are in deep blue; and, developing white blood cells are in lighter blue.
but we have data to suggest we should study that in much more detail.” “Now that we’ve also linked these mutations to graft-versushost disease and cardiovascular problems,” said Bhatt, “we have a larger study planned that we hope will answer some of the questions posed by this one.”
This work was supported by the National Cancer Institute (NCI) of the National Institutes of Health (NIH); Hyundai Quantum Award; Leukemia and Lymphoma Society Scholar Award; Eli Seth Matthews Leukemia Foundation; and, Kellsie’s Hope Foundation. The Washington University
Office of Technology Management has filed a patent application for “Ultra-rare Variant Detection from Next-generation Sequencing,” which has been licensed by Canopy Biosciences as RareSeq. Druley is a co-inventor on this patent. Canopy Biosciences was not involved in the generation of the data presented.
Vaccinations – adults get them, too OSF HealthCare Saint Anthony’s Health Center Special to Active Lifestyles
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See VACCINATIONS | Page 14
February 2020
child, they still need to know what immunizations are important as they move through adulthood, Dr. Roe said. A number of vaccines available to adults should be considered, she said. Example include: • Influenza vaccine – These are recommended for anyone age 6 months or older to protect against the influenza virus. The vaccine is offered seasonally and patients should get a flu shot by the end of October. Influenza is a respiratory illness that is caused by a virus. It can cause mild or severe illness and even death. The best way to guard against
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ALTON — When you think of immunizations, naturally the first thing that comes to mind are milestones of a child’s life – from the first vaccinations they receive when they’re just weeks old until the ones they get as they go off to college. But it’s important for adults to remember immunizations are something they also should discuss with their primary care provider. Dr. Laura Roe, with OSF Medical Group – Metamora, said there are several reasons
adult immunizations are a hot topic these days. “First, I think all of us becoming more and more focused on our health and preventive medicine – which include vaccines – is a major part of staying healthy,” she said. “Second, I think the overall attention to vaccinations in the media, especially in regards to childhood immunizations and the recent outbreak of measles across the country, has brought the issue into greater focus for adults. And third, in the past 20 years or so, there has been great advancement in adult vaccines against various diseases.” Immunizations for adults Even if an adult was fully immunized as a
Vaccinations
14 February 2020
Active Lifestyles
From page 13
getting the flu is to get a flu vaccine each year. • Tetanus vaccine – Tetanus vaccines are recommended for people of all ages. Tetanus is an infection caused by a bacteria. The bacteria produces spores found in the environment, in dust, dirt and soil. The spores can enter the body through broken skin, from an injury such as a cut or a puncture wound. Although tetanus is rare, it can cause serious health problems and even death. There are several vaccines that protect against tetanus as well as other illnesses. Most adults should get a Td booster every 10 years (this protects against both tetanus and diphtheria). Pregnant women should receive the Tdap vaccine (which protects against tetanus, diphtheria and pertussis/whooping cough) during the third trimester to help protect against whooping cough in infants. This can be given regardless of last tetanus immunization. Adults who have never received Tdap should also get one dose of Tdap in place of a dose of Td “I particularly remind patients who are going to be fathers, grandparents or coming in frequent contact with a newborn baby of this recommended vaccine,” Dr. Roe said. “Once you have had one Tdap dose as an adult, you don’t need to repeat the dose. It is important if you have a wound, such as a cut or puncture, that you check with your doctor to make sure your tetanus immunization is up to date.” • HPV vaccine – The HPV vaccine protects against human papillomavirus (HPV). HPV is a common virus that is passed by direct skin contact during sexual activity. Most sexually active men and women will get HPV in their lifetime. Most will not be aware they have been infected, as the virus often causes no symptoms. Some types of HPV can cause cancer and genital warts. HPV can cause cervical cancer, as well
as genital and oral cancer. The vaccine protects against the HPV types that most commonly cause cancer and genital warts. The vaccine is recommended in children starting at age 11, but some adults should receive the vaccine as well. For adults who did not receive the vaccine as a child, the HPV vaccine is recommended for men up to age 21 and women up to age 26. However, the Federal Drug Administration recently approved the use of the HPV vaccine in men and women ages 27 to 45. • Pneumonia vaccine – Pneumonia vaccines protect against specific strains of the pneumococcal bacteria. These bacteria commonly cause pneumonia as well as other infections. There are two different vaccines to protect against pneumococcal bacteria. The first is Prevnar 13 (PCV 13). This vaccine is recommended for all adults 65 or older as well as adults under 65 with an immune-compromising condition. The second vaccine is pneumovax 23 (PPSV 23). This is recommend for all adults 65 and older as well as adults aged 19-65 who smoke or have other chronic medical conditions. • Shingles vaccine – Shingles is a blistering, painful rash that can have lasting complications. It occurs in people who have had the chicken pox in the past and the chicken pox virus reactivates. There are currently two vaccines available for shingles: Shingrix
and Zostavax. Shingrix is the preferred vaccine as it is not a live vaccine and is more effective than Zostavax. • MMR vaccine – With the recent rise of measles cases, measles has been getting more attention. People born between 1957 and 1989 likely only received one dose of the measles vaccine. As a result, they may not be fully protected. Certain groups of people are at increased risk of contracting measles and should ensure they have had two MMR vaccines. Those include college students, health care workers and international travelers. Your doctor can help you determine if you need a booster or testing for measles immunity. • Hepatitis A and Hepatitis B – There are serious infections of the liver caused by a virus. The Hep A virus is transmitted by contaminated food or water. The Hep B virus is transmitted when blood or other bodily fluids enter the body of an uninfected person. The Hep A vaccine is recommended for all adults, but would especially be recommended for anyone who travels. The Hep B vaccine is recommended for certain populations, including people at risk for exposure to blood (such as health care workers and dialysis patients), people at risk for sexual exposure and people with hepatitis C, HIV or chronic liver disease. Protecting yourself and those around you
“Adults need to remember that immunizations are safe and effective with very few side effects,” Dr. Roe said. “Also, getting immunized not only protects yourself but helps to protect those around you. I sometimes have adults say they don’t need the flu shot because they are young and healthy, but they may be around young children or elderly people who are more vulnerable. “I would recommend any time you are unsure about whether a vaccine is needed, you should be asking your doctor, ‘Why should I get this vaccine?’ Often, I will have patients tell me they don’t need a particular vaccine, but when I explain why we have the vaccine and what the consequences of not vaccinating may be or how that vaccine could protect them, they often reconsider,” she said. “The bottom line is that the more information you have, the better you will be able to make a decision.” In addition, Dr. Roe recommends international travelers visit the Centers for Disease Control and Prevention, or the World Health Organization websites for travel advisories and information on vaccines and outbreaks by travel destination. Schedule an appointment with your doctor and ask about what vaccines you should be getting to protect yourself and those around you. If you need a primary care provider, osfsaintanthonys.org and click on “Find a Doctor.”
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February 2020
“OUR CAUSE IS YOUR CARE”
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Absolute Health Care Services provides considerate and respectful care while recognizing the diginty and individuality of all of our clients. Absolute Health Care Services realizes when a client or family needs to utilize our services, it can be an emotional time with questions and concerns. We want our clients and their families to be assured they have made the right choice about their loved one’s care.
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CANCER.
Will I be able to work? How will I Will I see my children grow up? W
Because no two cancers are alike, Anthony’s Health Center will pers needs. is why we designed th Will I be able to work? How will I get to treatments? Will I loseThat my hair? Will I see my children grow up? Where do I find hope?as an all-in-one facility, so you can getting back to your life.
It’s personal. CANCER.
ER.
It’s personal.
sonal.
Because no two cancers are alike, our team at OSF HealthCare Saint Anthony’s Health Center will personalize a treatment plan to meet your We’re by your side from diagnosis needs. That is why we designed the new OSF Moeller Cancer Center Becausetofor as an all-in-one facility, so you can focus on what is important youall – of us – it’s personal. getting back to your life.
by your side Will from diagnosis through treatment. Will I be able to work? How will I get to We’re treatments? I lose my hair? Because for all of us – it’s personal. Will I see my children grow up? Where do I find hope?
Because no two cancers are alike, our team at OSF HealthCare Saint To learn more, visit Anthony’s Health Center will personalize a treatment plan to meet your osfhealthcare.org/cancercare. needs. That is why we designed the new OSF Moeller Cancer Center as an all-in-one facility, so you can focus on what is important to you – getting back to your life. We’re by your side from diagnosis through treatment. Because for all of us – it’s personal.
To learn more, visit osfhealthcare.org/cancercare.
