Stem cell transplants, also called bone marrow transplants, treat high-risk and life-threatening blood diseases. The stem cell transplant team at UVA Health guides us through the procedure.
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Transcript
Karen Ballen, MD:
Stem cells are blood-forming cells that live in our bone marrow. When someone has a blood cancer such as leukemia, that bone marrow, the place that makes all of our blood cells, our factory for the blood cells, is damaged. What a transplant does is it gets rid of those damaged cells with high doses of chemotherapy, or in some cases, chemotherapy and radiation therapy, and then it replaces the abnormal bone marrow with completely normal bone marrow and blood-forming stem cells from a normal donor. The diseases that transplant is used for are cancers of the blood, such as leukemia, lymphoma, and multiple myeloma, and some other blood diseases that are very serious but are not cancer, such as sickle cell anemia or aplastic anemia. In general, the cure rate is between 40 and 70 percent. We want to make sure that the transplant is the appropriate treatment for each patient and that it is safe as possible, and each patient will undergo testing of their heart and lung function, kidney and liver function, to make sure that they're healthy enough for transplant.
Going through a stem cell transplant is a journey, and we're here with them every step of the way. For the patients, it's a big commitment. They may often be in the hospital for several weeks, and then for some transplants they need to stay here in Charlottesville for several weeks with a caregiver. After that, they'll return to their own home and the care of their own oncologist, and we'll work very closely with their local physicians to make sure that they're getting the best care possible, even if they're not here in Charlottesville. So my research is involved in making sure that every patient has a donor. 5 or 10 years ago, this was really a barrier to transplantation, and it's difficult for patients of non-European background to find donors in the registry.
John L. Wagner, MD:
You have larger numbers of patients that are eligible for therapy. When I started, if you were over 50, this wasn't an option. Now, the median age is about 66 or 67 for the patients.
Ballen:
But with modern techniques, using donors that may be a family member that might not be a match, using blood that is saved from the umbilical cord, and using other ways to prevent post-transplant complications, we've been able to find a donor for every patient. So we are doing research in what we call post-transplant maintenance, which is giving very low doses of chemotherapy or antibody therapy after transplant to prevent cancers from coming back. This is a novel treatment and is only available here at UVA Health. Third area of research is to prevent infections after transplant, and we've done some interesting studies looking at diet. And interestingly, we are looking at ways to change people's diet that may reduce the risk of getting infections in their gut or gastrointestinal tract after transplant.
Wagner:
UVA is a comprehensive cancer center. We are a relatively large program, and just like in certain surgical procedures, the more experience you have, the better your outcomes.
Ballen:
I think what makes our team so special is that we are just such a great team, and we're all really dedicated to the patient and making the patient the center of everything that we do.
