“Andrew Madoff has lost his courageous battle against mantle cell lymphoma,” Flumenbaum said.

Madoff was diagnosed originally with the slow-growing cancer at age 37, far younger than the typical case that affects men aged 50 or 60. The cancer is called mantle cell lymphoma because the tumor cells come from the mantle cells of the lymph nodes. He underwent successful chemotherapy and radiation treatment that staved off the disease until it recurred in 2012.

In May 2013, Madoff moved to Seattle for several months to receive a donor stem cell transplant at Fred Hutch. The first transplant failed, but a second stem cell infusion later that summer was successful, he said.

Madoff had no evidence of cancer relapse, experts said. But he suffered several bouts of skin and gut graft-vs.-host disease, in which the newly transplanted donor cells attack the recipient’s body. The acute GVHD had been in check recently thanks to powerful drugs, Madoff said..

“I’ve been feeling good,” he said on Aug. 26. “I’m feeling quite well. My health has not been perfect, but considering everything I’ve been through, it’s been good.

Madoff was scheduled to return to Fred Hutch this month for a review of his condition.

Andrew Madoff was the younger son of Bernard Madoff, whose massive Ponzi scheme bilked hundreds of investors of billions of dollars. Bernard Madoff was arrested in December 2008, pleaded guilty three months later and is now serving a 150-year-prison term.

Older son Mark Madoff committed suicide in 2010 on the second anniversary of his father’s arrest.

Andrew Madoff told Fred Hutch News Service that he wasn’t in contact with his father.

“He and I have never spoken since 2008,” he said. “That’s not something that I would pursue.”

He had been estranged from his mother, Ruth Madoff, but recently reconciled, he said.

Andrew Madoff was the subject of a lawsuit in July in which a trustee alleged that the sons knew more than they admitted and funneled away millions of dollars, tax-free.

Madoff told Fred Hutch that he couldn’t comment on the lawsuit. His lawyer told the CNBC news site that the allegations were “unfounded.”

The stress of his father’s crimes, the subsequent legal battles and his brother’s suicide all likely contributed to his cancer relapse, Madoff said.

“I think that there’s no question in my mind that stress plays an enormous role in your body’s ability to fight disease,” he said. “There’s absolutely a connection between the massive amounts of stress and the reason I relapsed.”

Madoff said he coped with stress through a rigorous low-carbohydrate diet and a fitness regime that included walking 5 miles every day, climbing 25 flights of stairs and strength training.

He told Fred Hutch he was optimistic about his prognosis and hoped to wean himself off the immunosuppressive drugs he was taking. He said he had hopes of contact with his stem cell donor.

“I would absolutely love to meet my donor,” he said. “I believe it was a young German fellow in his 20s. I’d love to fly over there and have a beer with him.”

Andrew Madoff was an engaging young man who was grateful for the care he received at Fred Hutch, said Appelbaum.

“He did not make any requests or demands for care other than we make for any of our patients,” Appelbaum said Wednesday. “He understood that a system works best when it is not perturbed.”

There was no question about whether to treat Andrew Madoff, despite the controversy surrounding his family, Appelbaum said.

“We’re not here to make judgments; we’re here to treat patients,” he said.

Bernard Madoff’s admitted acts left his family to grapple with shame and disgrace, but Andrew Madoff said his own experience had been overwhelmingly – and surprisingly -- positive.

“Other than commenters on blogs and internet trolls, I have not seen any of that negativism,” he said. “The number of people who’ve reached out with something mean is almost zero.”

Instead, he heard from people who encouraged him during his cancer ordeal and wished him well.

“The number of people who’ve reached out to me with positive messages is staggering,” he said. “It’s been wonderful.”

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JoNel Aleccia is a staff writer at Fred Hutchinson Cancer Research Center. From 2008 to 2014, she was a national health reporter for NBC News and msnbc.com. Prior to that she was a reporter, editor and columnist for more than two decades at newspapers in the Northwest. Reach her at jaleccia@fredhutch.org.