Dana-Farber’s 1000th CAR T-cell Therapy Recipient Praises Partner and Program 

The first time Jackie Dunn tracked her husband Mike’s numbers, he was a high school basketball star and she was the team statistician. More than 40 years later, she was back at it — this time with far more on the line than a ballgame. 

The Dunns had temporarily relocated in the summer of 2024 from their Loudonville, New York home to Boston, where Mike was undergoing treatment for multiple myeloma. Traditional chemotherapy, as well as a stem cell transplant, had failed to control the cancer in his bone marrow from progressing. This meant that CAR T-cell therapy — a form of immunotherapy in which T cells are removed from a patient’s bloodstream, genetically modified to target specific antigens on cancer cells, and then reinfused as CAR T cells — would be critical to Mike’s long-term survival.  

So would Jackie. 

For 42 days, starting in early July, Mike was treated as an outpatient in the Cellular Therapies Program at Dana-Farber Brigham Cancer Center. This included preparatory chemotherapy, the CAR T cell infusion, and several weeks of surveillance to ensure his body’s immune system responded well to the reinfused CAR T cells and to monitor for side effects. The Dunns, who secured an Airbnb apartment nearby, developed a routine for getting through this challenging period — which also included a pair of hospitalizations due to complications. 

Each morning the couple drove to Dana-Farber for monitoring by Mike’s clinical team, led by Omar Nadeem, MD, clinical director of the Myeloma Immune Effector Cell Therapy Program (IEC) in the Jerome Lipper Multiple Myeloma Center. Once back at the house, Jackie spent the rest of the day and night closely tracking Mike’s vital signs and relaying them to the IEC team. Jackie also had Mike write out sentences and answer a series of questions to ensure he was not suffering any cognitive issues as a result of the powerful treatment.  

“I was back to being his statistician,” Jackie says with a smile. 

The two-pronged approach was effective. With the help of Mike’s newly reprogrammed CAR T cells, his myeloma was undetectable, and the Dunns returned home in mid-August. A few months later, as he continued recovering and the couple readied for Thanksgiving with their two adult daughters, they learned Mike had been the 1000th patient to receive CAR T-cell therapy at Dana-Farber Brigham. They were honored by the distinction, but Mike and Jackie agreed there were far more important numbers on their minds: the additional birthdays and wedding anniversaries they were now planning to celebrate together. 

“Jackie and I have been a team for a long time,” says Mike. “The team at Dana-Farber allowed her to be the best caregiver she could be, and together we formed a great partnership.” 

The next frontier 

Initially offered in clinical trials for patients with leukemia and lymphoma in 2015, CAR T-cell therapy is now benefiting individuals living with a growing number of different blood cancers. Dana-Farber Brigham, which in 2017 became one of the first cancer centers to offer CAR T-cell therapy as standard of care, has experienced a dramatic rise in the number of those able to benefit from it. 

“Our ability to treat 1000 patients with CAR T-cell therapies so quickly, from the inception of our program to present, is a testament to the tremendous support Dana-Farber leadership has provided for its growth and expansion,” says Caron Jacobson, MD, MMSc, medical director of the IEC Program. “That support has provided our patients with ready access to this groundbreaking, and lifesaving, novel therapy. Our next frontier is to expand our capabilities by treating more and more patients in the outpatient setting, and to move beyond blood cancers and into the more common and more difficult to treat solid tumors. 

The move to outpatient CAR T-cell therapy — which saves some patients lengthy inpatient hospital stays and improves patient comfort — is already well under way at Dana-Farber Brigham.

In order to deliver the therapy in an outpatient setting, patients are required to stay within 30 minutes of Dana-Farber and neighboring Brigham and Women’s Hospital for seven to 10 days after their CAR T infusion in case of side effects and complications. If they live more than two hours away, they need to find short-term accommodations near the hospitals for up to 30 days post-procedure. Because Dana-Farber boasts one of the world’s most experienced CAR T-cell teams, many patients are willing to make this commitment.  

Another precondition is that they have a dedicated caregiver with them at all times for 30 straight days to monitor them for signs of side effects of the CAR T cells and notify the patient’s oncologist. The latter was certainly not a problem for Mike Dunn. He and Jackie were childhood neighbors who grew into teenage sweethearts — dubbed “Class Couple” of 1983 at Rensselaer High School. They stayed steady through college, married, and raised their daughters Kirsten and Skyler just a few miles from where their romance had blossomed. When Mike coached the girls’ basketball teams, Jackie was there beside him keeping stats.  

After Mike suffered a back injury the weekend of Kirsten’s wedding, in October 2021, examining doctors noticed he had an extremely low blood count. This led to more tests and eventually a multiple myeloma diagnosis. Oncologists in New York gave him two years to live, but their lack of empathy or treatment options beyond standard chemotherapy led Mike and Jackie to seek a second opinion. 

“As soon as we walked in the door at Dana-Farber, you could feel the difference. It was like a breath of fresh air,” recalls Jackie. “Dr. Nadeem took Mike on as a patient right away, and his team gave us optimism.” 

Compassion in crisis 

Under Nadeem’s care, after six rounds of preparatory chemotherapy back in New York, Mike underwent a stem cell transplant at Dana-Farber in March 2022. He initially responded very well, but then a bout of COVID in early 2023 wreaked havoc on his immune system. Soon it was clear the myeloma had progressed after the transplant.  

“Michael’s myeloma progressed on standard therapies and we discussed that CAR T-cell therapy would give him the best chance for long term disease control,” explains Nadeem. “He was considered a great candidate for outpatient administration of CAR T cells, which has now become our standard method of giving cilta-cel [a drug used for relapsed myeloma]. Mike was overall in good physical condition, and also had a wonderful caregiver in Jackie, who would be able to fulfill the requirements of monitoring his vital signs and providing support.”  

Mike and Jackie are quick to share the credit with Nadeem and his team, especially oncology nurse navigator Liz Kendricken, BSN, RN. 

“From day one, Liz was always answering questions about medications, addressing vitals, helping us find temporary housing, and providing an empathetic ear, respect, critical thinking, and compassion,” says Jackie. “She, Dr. Nadeem, and the entire team gave us hope during a very dark time.” 

Now they are back home, and Mike’s myeloma remains undetectable. They continue to be monitored by Dana-Farber, and if the need to find another treatment option ever arises, they won’t hesitate to travel to Boston again. 

About the Medical Reviewer

Dr. Nadeem completed his internal medicine residency training at Dartmouth-Hitchcock Medical Center and his hematology/oncology fellowship at the Warren Alpert Medical School of Brown University. He joined the Jerome Lipper Multiple Myeloma Center at Dana-Farber Cancer Institute in 2018 where he is a Senior Physician and serves as the Clinical Director of the Myeloma Immune Effector Cell Therapy Program and as the Clinical Director of the Center for Early Detection and Interception of Blood Cancers. He is an Assistant Professor of Medicine at Harvard Medical School and is board certified in internal medicine, hematology, and medical oncology. He is an Associate Director of the Myeloma Clinical Research Program and serves as a principal investigator on several clinical trials ranging from precursor plasma cell disorders to relapsed and refractory multiple myeloma. His research interests include MGUS and smoldering myeloma and immunotherapy in multiple myeloma, with particular focus on CAR T-cell therapy.