Blood and Marrow Stem Cell Transplantation
Introduction
Certain cancers of the blood, bone marrow and lymph nodes are best treated with stem cell transplantation. In this procedure, patients receive high doses of chemotherapy (and sometimes radiation), leading to better control (even cure) of the cancers than can be achieved with standard doses of chemotherapy. However, the main side effect of the high doses of chemotherapy is prolonged suppression of the body’s ability to make blood. To get around this side effect, the patient receives an infusion of “stem cells” obtained from a healthy related or unrelated donor (allogeneic transplant) or from the patient him- or herself collected before the chemotherapy (autologous transplant).
The stem cells are actually called “hematopoietic stem cells”, and they are cells that serve to make new blood cells and immune cells. They can be obtained either from the bone marrow (“bone marrow transplant”) or from the blood stream (“blood or peripheral blood stem cell transplant”). (By the way, these hematopoietic stem cells are normal mature cells from adults and are completely different from “embryonic stem cells,” which have become a source of much ethical and political discussion of late.)
The stem cell transplant process is very complicated, but an experienced and comprehensive team delivers the procedure safely. The Transplantation Program is a designated transplant center of the National Marrow Donor Program (NMDP) and is an Aetna Institutes of Excellence Transplant Network Program.
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Eligibility
Eligibility for stem cell transplantation depends on particular characteristics of the disease and particular characteristics of the patient. General eligibility guidelines for transplantation at UT Southwestern are as follows:
Patient characteristics:
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Appropriate diagnosis and disease status.
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Age within recommended parameters
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Autologous: ≤ 70 years of age. Selected patients over age 70 may be eligible for autologous transplants if in good physical condition.
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Allogeneic: ≤ 60 years of age. Selected patients over age 60 are eligible for allogeneic transplants using less-toxic treatment regimens.
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Good performance status.
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No other significant concomitant illness
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Adequate organ function
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HIV negative
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Results at UT Southwestern
Stem cell transplantation is a very complicated process but is delivered safely by an experienced and comprehensive team. The UT Southwestern Stem Cell Transplant Program has been very carefully constructed to deliver state-of-the-art transplants safely and effectively and has compiled an outstanding track record.
Number of transplants (through 09/30/2004)
Autologous 105
Allogeneic 57
Day 100 treatment-related mortality
Autologous 1.5%
Allogeneic 4.0%
One-year survival
Autologous 84%
Allogeneic 58%
(myeloablative regimen)
Allogeneic 86%
(nonmyeloablative regimen)
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