For three decades, experienced cancer specialists at University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center (UMGCCC) have offered patients hematopoietic stem cell transplantation as an effective treatment option to manage blood cancers like leukemia, lymphoma and multiple myeloma.
Stem cell harvest and transplant harness the benefits of hematopoietic stem cells (HSCs) that live in blood and bone marrow. Specifically, HSCs help rebuild the hematopoietic system, which is responsible for producing fresh and healthy blood. Stem cells may be harvested from a donor’s blood, or from bone marrow that has been surgically removed from a donor.
“Stem cells serve as a repair system for the body. They can regenerate and repair the tissue where they reside,” said Saurabh Dahiya, MD, FACP, assistant professor of medicine in the Division of Hematology and Oncology at the University of Maryland School of Medicine (UM SOM) and oncologist at UMGCCC. “In patients with certain cancers, primarily blood cancers and certain solid tumors, hematopoietic stem cell transplants provide a potential cure for these conditions.”
Obtaining HSCs: Bone Marrow Retrieval
Patients may receive HSCs from donors, or they may rely on their own stem cells that have been harvested before they became ill. Donated HSCs are known as allogenic transplants, while using your own previously collected stem cells is known as autologous transplant.
At one time, bone marrow retrieval was the most common method of obtaining HSCs for transplant, and this method is still fairly common today. It requires the donor undergo a minor surgical procedure under general anesthesia.
In bone marrow retrieval, the transplant team removes a small amount of the donor’s bone marrow, a sponge-like tissue inside of the bones, in the operating room. The bone marrow is then transplanted into the patient. Bone marrow donations from donors who live far away from the recipient may be frozen prior to transplant.
A Nonsurgical Approach: Apheresis
For many years, surgical bone marrow retrieval has been the standard approach for obtaining HSCs from either donors or the patients themselves. Today, doctors can frequently use a technology called apheresis to obtain HSCs from the donor’s blood, without the need to harvest bone marrow. This makes the process far easier on the donor.
In apheresis, providers remove the donor’s blood through a vein in the arm, neck or chest. They then run the blood through a machine that gathers stem cells. Once those cells have been collected, the donor’s blood is returned and the stem cells are frozen and stored until transplantation.
The Engraftment Process
Whether HSCs are harvested through bone marrow retrieval or from blood via apheresis, they are ultimately transfused into the patient’s blood stream, where they travel to the patient’s bone marrow. In the marrow, these cells start to produce new red and white blood cells and platelets. This process, known as engraftment, may take between 10 and 16 days after transplantation to occur.
To determine whether new blood cells are being created, doctors will check the patient’s blood counts on a daily basis and/or remove and examine small samples of bone marrow.
“Bone marrow transplants are complicated procedures that require a very skilled team of providers and physicians. That infrastructure exists at the University of Maryland Medical System,” Dr. Dahiya said. “Our team at UMGCCC includes physicians, nurses, pharmacists, technicians and nurse coordinators who have been working together for several years. They perform these procedures safely, effectively and efficiently.”
Dedicated to Enhancing Outcomes
The multidisciplinary transplantation team at UMGCCC has a track record of performing above the national average for clinical outcomes for patients who receive bone marrow transplants. But that does not mean that they are content to stick with the status quo.Â
Blood cancer and stem cell specialists at UMMS are involved with a variety of clinical trials that are designed to increase the benefits and efficacy of hematopoietic stem cell transplants while also enhancing the safety of procedures.
“There is hope in hematopoietic stem cell transplantation and the effects it may have on a variety of cancers,” said Curt Civin, MD, associate dean for research and professor of pediatrics and physiology at UM SOM. “We are hard at work finding ways to extend that hope to patients affected by cancers that do not respond to current approved therapies.”
In addition to clinical solutions, UMMS cancer centers across the state offer wellness programs that focus on mental health, nutrition and physical therapy to help optimize patient outcomes.
Leading-Edge Care Close to Home
Innovative cancer care is within reach. Led by the UMGCCC, the University of Maryland Cancer Network provides access to national experts, the latest treatments, including stem cell therapies, and promising clinical trials. When you work with a UM Cancer Network cancer center, you can get the care you need at a community hospital close to home while benefiting from the connection to an NCI-designated Comprehensive Cancer Center.
