Bone Marrow Transplantation

Chimeric antigen receptor (CAR) engineered T cell technology is one of the most exciting areas of emerging treatment for cancer. Special immune cells called T cells can be harvested from a patient’s peripheral blood. These can then be manipulated in a laboratory to express CARs on their surface, rendering the CAR-positive T cell highly effective at attacking leukemia. Our team and other members of the Cancer and Blood Diseases Institute have partnered with industry to provide additional options to some of our patients with hard-to-treat leukemia. A variety of treatment platforms are either currently available or actively in development.

Vitamins are an important part of maintaining a healthy physiology and metabolism. They also serve essential roles in a balanced and controlled immune system. Stella Davies, MBBS, PhD, and other members of the Bone Marrow Transplantation team are currently exploring the role of vitamins A and D in patients who have received a hematopoietic stem cell transplant. These vitamins may provide protection against graft-versus-host disease and infections within the intestine after a transplant. Patients’ levels are monitored closely during the transplant process to ensure adequate vitamin levels. Ongoing research exploring the interplay between your body’s vitamins and transplant success is currently under way. 

Blood vessels are an important organ system of the human body. They can also be affected by the administration of a hematopoietic stem cell transplant. Sonata Jodele, MD, and other members of the Bone Marrow Transplantation team have explored many aspects of TA-TMA including the role of a group of blood proteins called complement. She has pioneered the use of complement-blocker medications that can be used to reverse the effects of this transplant-related complication. As such, her work is highly referenced, and our center has been internationally recognized as establishing new standards of care for this entity. Learn more.

Our research has succeeded in the development of reduced intensity conditioning (RIC) regimens, a transplant procedure that offers lower doses of chemotherapy, which can offer improved outcomes by decreasing the unwanted effects of a transplant. We have pioneered the application of this RIC approach to diseases such as hemophagocytic lymphohistiocytosis (HLH), a pro-inflammatory condition that carries significant life-threatening risks.

Your bone marrow transplant attending doctor will determine if you are eligible to participate in any of our current research studies.

Chemotherapy and other medications used in hematopoietic stem cell transplant have potential unwanted secondary effects. Bone Marrow Transplantation team members Rebecca Marsh, MD, Sharat Chandra, MD, and Parinda Mehta, MD, are actively researching existing and emerging technologies that can monitor drug levels in real time. These new techniques will allow for the most accurate administration of medication while minimizing toxicity wherever possible. 

Graft-versus-host disease (GVHD) is a significant risk of allogeneic (a donor) HSCT. GVHD is caused when the immune cells from the donor (graft) recognize your body (host) as foreign and cause a reaction. This can cause damage to tissues or organs in your body that can range in severity from mild to life-threatening. Rebecca Marsh, MD, and Pooja Khandelwal, MD, have been working hard to delineate the importance of certain cell populations that emerge early in the post-transplant period as possible GVHD markers. They utilize flow cytometry, a laboratory technique that characterizes immune cell populations, to detect the presence of cell-surface proteins like CD38. Additionally, Khandelwal is studying methods that can detect subtle signs of graft-related inflammation in the skin using sensitive patches. Lastly, their work has also assisted in clarifying the role of novel approaches to treat refractory GVHD.

HSCT can be a challenging process, and our team continues to improve the patient experience. Christopher Dandoy, MD, is a clinician scientist with a research niche that utilizes a number of quality control and improvement measures. He works hard with our nursing and ancillary staff to create initiatives that address patient safety, comfort and satisfaction. Some of these endeavors include trials that:

• Evaluate sleep
• Minimize unnecessary vital sign checks
• Decrease the incidence of bacterial infections
• Improve cleanliness and hygiene

Your bone marrow transplant attending doctor will determine if you are eligible to participate in any of these research trials.