Walter Robert Keller, 1953-2014
In late 2011, I saw a story in the New York Times. A clinical trial of a new kind of cancer therapy at the University of Pennsylvania had jolted two elderly leukemia patients into apparent remission. The therapy had never been tried before in humans, only in mice. Developed over 25 years by a team of Penn doctors, it used genetic techniques to give new powers to a patient’s own cells, transforming them into “serial killers” able to attack and eliminate tumor.
It seemed to be one of those rare moments in cancer science when an experimental treatment actually worked. I wanted to know more, so I asked Penn if they’d connect me with a patient. They pointed me to Walter Keller, a cabinet refinisher in Southern California, the seventh adult to ever receive the therapy.
In October 2012, I flew to California to visit him. He met me at the airport with a big grin. He was tall and wiry, with leathery skin, green eyes, and short spiky hair. We went to lunch at an Italian restaurant and he started telling me about the trial. He said that when he first signed up to receive the treatment, he knew he was almost out of time. He’d been battling chronic lymphocytic leukemia, the most common form of leukemia, for 14 years, and chemo wasn’t working anymore. His body contained up to seven pounds of tumor. He required constant transfusions of blood products to stay alive. His California oncologist was telling him to put his affairs in order. He saw the trial as his last chance.
The treatment, which had begun in May 2012 in Philadelphia, wasn’t easy for Walt. The way the therapy works, it uses the body as a sort of bioreactor to grow armies of cells that attack the tumors with great violence. There are temporary side effects. Because Walt was one of the earliest patients, doctors didn’t know as much as they do now about how to manage the side effects.
About a week after he received his first treatment, he became very sick. He spiked a fever, shook with powerful chills known as “the rigors,” and began to babble about Elvis. Delusional, he kept trying to escape his hospital room. His kidneys started to shut down. There were times when his family thought he might die. (His eldest sister, Nancy Nelson, was there by his side, having left her job and her family in California for 11 weeks to support Walt through the trial. Also present were Walt’s three adult children: his daughters, Chelle and Shawna, and his son, Dustin.)
But with the help of Penn’s doctors and nurses, and the backing of his loved ones, Walt pulled through. The fever went down, the chills disappeared. He regained his senses. And incredibly, just shy of a month after his first treatment, when doctors took a biopsy of his bone marrow and analyzed it using their most sophisticated tools, they couldn’t find any evidence of cancer. He had entered the hospital a dying man, and he would leave it in remission. “I give all the credit to doctors,” Walt told me, “and to God.”
He said that while I was here in California, he wanted to show me some of the things he cared about, some of what made his life worth living. He had been coaching Pony League baseball for years, and he also liked to give free private lessons for his players in the batting cage he’d built in his backyard, complete with a pitching mound. My second morning with Walt, three of his players showed up at his house, boys named Michael and Joshua and Cody in white pants and hunter-green shirts. In the backyard, they took turns throwing fastballs as Walt stood on his small lawn in the sun, wearing a black T-shirt, sunglasses, jeans, and white New Balances, marveling at his players’ smooth, nearly identical pitching motions. “You see how they all have the same mechanics?” he asked me. “That’s because they all come to my house.” He laughed. “It’s my way or the highway.”
Walt was proud of his role in the Penn trial. He wanted to be the best patient and the best advocate for the science he could be. He said he hoped his journey would benefit other patients down the line. “Good things that happen spread,” he said. “And [the doctors] learn from each patient, and apply what they’ve learned to the next patient, so every person down the line, it gets easier and easier.” He thought the story of the trial might give hope to other people out there who were suffering. He asked me a couple of times, shyly, but with wide eyes, if he thought we could ever be on Oprah together. That was the kind of audience he wanted to reach.
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Last July in Calfornia, after my story about Walt and the Penn doctors had gone to press, Walt went to get some cancerous skin lesions removed from his right inner thigh. He’d had problems before with lesions like this, and the procedures had gone smoothly. This time, though, when the doctor removed the lesions, the wound became infected, and the infection spread to his blood. Walt was hospitalized in August with septic shock.
Over the next several months, he spent time at four different hospitals, battling infection and wounds from the infection. The wounds spread from his waist all the way up to his shoulder. He was reluctant to go home and begin hospice care, because to him, hospice care meant he was going to die. He wanted to keep fighting; he wanted to see his four grandchildren grow up. But the pain became too much to bear, and earlier this month, he went home. Last Tuesday, in the early morning hours, when it seemed like he was worsening, his family gathered around.
“Everybody told him they loved him,” Nancy said, “and he fought a good fight, and they were proud of him, but it was time for him to go.” He died on Tuesday, surrounded by loved ones. He leaves behind his wife, Robin; his three children; his siblings, Nancy, Judi Lauer, Kurt, Steve, and Jon Keller; and the grandchildren.
The therapy developed by Penn doesn’t only destroy cancerous cells. It also eliminates certain normal cells that help the body fight infection. (Some of that function can be restored with injections of blood plasma proteins.) I asked Penn if there was any link between Walt’s final illness and the trial. Dr. David Porter, the oncologist who cared for him during the trial, responded via email: “At the time of his passing last week, Walt’s leukemia had been in remission for more than 18 months following the therapy he received as part of this clinical trial. At this point, we aren’t able to determine whether there was any connection between the illness that led to his death and the trial protocol.”
About 30 adults and 20 children with leukemia have received the therapy since Walt was first treated, and the outcomes have been dramatic and promising. In December, the Penn team presented results from all 59 patients so far. Forty-seven percent of adult patients with chronic lymphocytic leukemia experienced at least a partial response to the therapy, and seven patients went into complete remission. Also, 86 percent of children with a related disease, acute lymphoblastic leukemia, had complete remissions. Some later relapsed, but out of the first three adult patients treated in the summer of 2010, two are still in remission more than three years later, and the first child is in also remission after almost two years.
According to Nancy, Walt remained proud of his involvement in the trial until the very end, and grateful that it had extended his life. “He got a year and a half that he wouldn’t have had otherwise,” she said. Walt even tried to give one last blood sample for the trial in his final hours, although it didn’t work; he was too sick.
David Porter called Walt “one of the strongest, bravest and kindest people I have encountered in all my years as an oncologist…. It is because of people like him that we can continue to hope and make progress against cancer, and I, and everyone in our group, will miss him.”
I only knew Walt enough to realize it was a privilege to help tell his story. He was a good person who made a difference. His bravery may help extend many lives. Rest in peace.
Walt Keller's fight with leukemia was chronicled in the August 2013 issue of Philadelphia magazine. Read his story in the e-book Patient No. 7, available for e-readers, tablets, phones and desktop computers at Amazon’s Kindle store.