Setting an Example for Excellence in MDS Treatment

Dr. Rafael Bejar has focused on myelodysplastic syndromes (MDS) and related blood disorders since some of the earliest days in his medical career. During his second year of fellowship, he worked out of a lab that was doing patient-facing research, where each of his findings had the potential to impact clinical patient care. He found himself working alongside a colleague who had a huge collection of MDS patient samples.

“One of the things that was missing in the MDS world at the time was people doing studies on actual MDS patient samples. A lot of the work had been done on mouse models or cells in a petri dish, so it was less relatable to the actual disease,” he said. “So I started to work with this unique resource and we were able to make some headway: we started to understand the genetic underpinnings of MDS, what mutations people were acquiring as they developed the disease.”

Fast forward fourteen years, and Dr. Bejar has continued to dedicate his attention to MDS. Now, he’s in his tenth year at UC San Diego Health (UCSD), where he’s established a MDS Center of Excellence and provides critical patient care every single day. He’s also served as an advisor for designing clinical studies, worked with the MDS Foundation as a member of their scientific advisory board, and participated in the running of numerous clinical trials, too. After all of this time, he remains dedicated to the field.

“Hematology is this area where a tiny genetic mutation in one cell could lead to this entire disorder; and if we really could understand that at a very basic level, we could prevent and treat these conditions much better,” he said. “We’re also able to access the cells themselves. This isn’t a tumor that’s deep in the body. Instead, we can get living cells out of the bloodstream or out of the bone marrow and examine them.”

In order to establish the UCSD Moores Cancer Center as an MDS Center of Excellence, Dr. Bejar had to ensure the center was built on four critical pillars: research, clinical trials, transplant, and hematopathology – all in one central, physical location. In practice, he’s found that this designation often allows the Moores Cancer Center team to make connections with other practitioners in order to help ensure their patients get great care, whether at the diagnosis or treatment stages.

Dr. Bejar also makes a point to continue to partner with patient advocacy groups, MDS support groups, and organizations like the MDS Foundation and the Leukemia and Lymphoma Society. At every corner, Dr. Bejar works to make all information as accessible as possible, including leveraging his bilingual skills to lead sessions in Spanish.

It’s this prioritization of patient care, and the embracing of every patient’s uniqueness, that is at the root of all of Dr. Bejar’s work.

“I think one of the dangers with having more technology is that we kind of forget about the patient. It’s very easy to just look at the blood counts and the bone marrow results and jump to what you need to do next,” he said. “But now, the hematology field is incorporating more patient reported outcomes in our clinical trials so the subjective experiences of the patients are coming through in the results of each study. We’re thankfully in a very different place with MDS today than we were fifteen years ago.”