Q&A With Director of Program Among Top-Ranked in US for One-Year Survival
For the fourth consecutive year, the聽聽in the Division of Hematology and Cellular Therapy聽at Cedars-Sinai has achieved higher than expected survival rates in patients receiving allogeneic stem cell transplantation, according to a recent report from the Center for International Blood and Marrow Transplant Research.
Allogeneic transplants use blood stem cells from donors鈥� bone marrow to treat patients with blood and bone marrow diseases.聽The Cedars-Sinai team performs more than 40 such transplants each year.
Among the 178 U.S. centers included in the report, Cedars-Sinai is one of only 12 that exceed national survival expectations for allogeneic transplants. Its one-year survival rate is 85.8%. Expected survival rates for similar patients receiving transplants at other U.S. centers are between 68.8% and 83.1%.
John Chute, MD
鈥淥ur success in hematopoietic stem cell transplantation is a testament to an outstanding team of dedicated people who work seamlessly together toward one goal鈥攇iving the patient the best possible experience and outcome,鈥� said聽, director of the聽聽at Cedars-Sinai. 鈥淚t is an honor to be among the top allogeneic transplant centers in the country. It鈥檚 an even greater honor to see patients year after year at their follow-up visits, back to living the life they did before they became ill.鈥�
罢丑别听Cedars-Sinai Newsroom聽recently sat down with聽, clinical director of the Stem Cell and Bone Marrow Transplant Program and director of Myeloid Malignancies at Cedars-Sinai Cancer, to discuss bone marrow transplantation. 聽
Tell us about marrow transplants and why they are performed.
Bone marrow is the soft tissue inside your bones, and it contains stem cells that make the body鈥檚 main blood cells. Marrow transplantation is used to treat diseases of the bone marrow and blood鈥攃ancers like leukemia, lymphoma and myeloma. It involves replacing unhealthy blood cells with healthy ones. Before transplant, patients undergo chemotherapy with or without radiation to destroy abnormal cells and suppress the patient鈥檚 immune system to prevent rejection of the donor cells.
When would an allogeneic transplant be performed?
We most often use allogeneic transplant to treat acute leukemia because it offers patients the best chance of a cure. It involves transferring healthy stem cells from a donor to a patient, as opposed to using stem cells from the patient鈥檚 own body鈥攚hich is called autologous transplantation. The donor is most commonly someone related to the patient, but they don鈥檛 have to be a relative.
What makes for a successful allogeneic transplant?
Our preferred donors are young relatives, most commonly children, of the patient. Modern transplant methods allow us to use related donors who share only half of the tissue proteins of the patient. Close to 85% of our transplants are performed using such half-matched donors. In the past only fully matched transplants could be considered. A biological child of the patient will always be a half-match donor, and that can help get the patient to transplant more quickly and with excellent success rates. Also, the younger stem cells of children can provide greater benefit than older cells from another family member, such as a sibling. Once we鈥檝e identified a half-match donor, we can typically get someone to transplant in about six weeks versus three months for an unrelated donor.
What does Cedars-Sinai do to exceed national survival expectations?
Ronald Paquette, MD
We鈥檝e been able to reduce the risk of graft-versus-host disease by using high-dosage chemotherapy after transplant. This is an approach that we adopted at Cedars-Sinai about seven years ago with great success. We also work to ensure patients are in the best possible remission before transplant so that their risk of relapse is less. We try to minimize treatment-related toxicity because if patients are too worn down at the time of transplant, they鈥檙e going to have a higher risk of complications. We鈥檝e also been able to extend transplantation to older patients, up to age 75. Historically, the risks have been high for this group, but thanks to our work to hone safe and effective regimens, we鈥檝e had good success.
The unique and valuable experience at every level of our transplant team is remarkable. Our physicians, transplant coordinators, nurse practitioners, dedicated nursing staff, oncology pharmacists, psychosocial specialists, quality assurance nurses and administrative staff all work together to improve patient outcomes and satisfaction. We鈥檝e found a formula that works, and we continue to stay up to date on the most innovative treatments for our patients.
