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10,000 BMTs — and counting 

 


By Wayne Lewis


City of Hope performed its 10,000th hematopoietic cell transplant on Jan. 13. The feat marked a major milestone for a program that remains a leader in the field.

Photo from the annual transplant reunionHundreds of survivors now return to City of Hope for the annual transplant reunions. (Photo by AmyCantrell.com)
Sometimes called bone marrow transplantation, hematopoietic cell transplantation (HCT) is a therapy for patients with life-threatening cancers and other blood and immune system disorders.

Physicians use HCT to establish a new, disease-free blood and immune system by transplanting healthy blood stem cells.

The journey toward the 10,000th such transplant was only possible through the bold first steps of pioneers in the field who believed the experimental treatment could save patients once told they could not be cured.

Humble beginnings

The City of Hope HCT story began nearly 35 years ago with one of the first teams anywhere to perform a successful transplant.

Now the program performs more transplants than any other center in the state. It’s also one of the largest and most successful in the world.

“In the early days, this was a therapy of uncertain efficacy, done at a very small number of places. Our results helped validate that this could work to cure patients. Now it is a standard of care for the treatment of many diseases,” said Stephen J. Forman, M.D., Francis and Kathleen McNamara Distinguished Chair in Hematology and Hematopoietic Cell Transplantation and chair of the Department of Hematology & Hematopoietic Cell Transplantation.

Since then, City of Hope’s treatment program has saved more than 36,000 years of life.

That success has given hope to patients who lack a matching donor within their families. They must rely on stem cells from unrelated donors, sometimes half a world away.

Unrelated donor procedures can have dangerous complications, especially among the sickest patients. But the National Marrow Donor Program recently reported that City of Hope’s Matched Unrelated Donor Program is the only one nationwide to achieve above-expected survival outcomes for five consecutive years. 

The influence of HCT

City of Hope research continues to lead to advances. New approaches improved cure rates, extended the procedure to older patients and expanded HCT to diseases beyond leukemia, lymphoma and multiple myeloma.

Photo of Stephen FormanStephen Forman has led the transplant program since 1978. (Photo by Walter Urie)
Researchers now study a strategy called radioimmunotherapy, in which specially designed immune molecules deliver targeted radiation directly to cancer cells. This approach has shown promise for lymphoma and is now being extended to leukemia.

Scientists also have adapted HCT to tackle HIV/AIDS. They’ve coupled HIV-fighting gene therapy with HCT, seeking to cure patients of HIV-related lymphoma while also blocking the virus that causes AIDS.

Although HCT has come a long way, challenges remain. City of Hope laboratory and clinical scientists strive to make HCT safer and more effective. Their ultimate goal: help extend the length and quality of life of patients at City of Hope and around the world.

Said Forman: “At the end of the day, all of our efforts are about our commitment to patients and their families — recognizing each of them as a dignified human being with a story to tell and a life to live. They also are our partners in developing new therapies for those who will come to us tomorrow for care. There’s an enormous number of people who are alive today because they were and are a part of something we did at City of Hope that was both bold and new. And that number continues to grow.” 

 

Transplants at a glance — more than three decades of lives renewed

  • City of Hope performs more than 500 transplants a year (about 45 per month).
  • City of Hope’s Bone Marrow Transplant (BMT) program is the largest in California.
  • The youngest patient to undergo transplant was 4 months old. The oldest patient was 79 years old at the time of transplant.

In 1976 …

  • … transplants could only be performed between matched sibling donors. Now, unrelated donor transplants are more common.
  • … there were three BMT staff physicians in the program. In 2011, more than 30 physicians and more than 100 scientists work in the program.
  • … City of Hope had fewer than 10 transplant nurses; now there are more than 400.
  • … it was rare to transplant a patient over the age of 30. Now, patients can undergo transplant well into their 60s and even 70s.

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