Adult Bone Marrow Transplant

Cancer (Oncology)

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Adult Bone Marrow Transplant Program At NewYork-Presbyterian Hospital/Columbia University Medical Center

NewYork-Presbyterian/Columbia's Bone Marrow Transplant Program has begun performing haploid identical bone marrow transplant. The procedure involves using a donor – a sibling, parent, or child – who is half-matched to the recipient. This enables the expansion of the donor pool for nearly all patients, increasing the likelihood of an available donor. NewYork-Presbyterian/Columbia is the only center in the New York area to have the technology to perform T-cell depletion–the removal of T-cells from the donor marrow that makes haploid transplants possible. For people who have no alternative donor options, using very high doses of donor cells and removing as many of the T-cells as possible can result in successful outcomes.

Through its Cellular Immunotherapy Research Laboratory, NewYork- Presbyterian/Columbia is exploring vaccine therapies for treating a number of different malignancies. The vaccine therapy would be administered after a patient has had a transplant and completed a chemotherapy regimen. Clinical trials have been FDA approved for metastatic kidney cancer and melanoma, with approvals imminent for a variety of other cancers, including breast cancer and lung cancer.

The number of allogeneic (from a donor) transplants performed at NewYork-Presbyterian/Columbia continues to expand, with a particular focus on managing the toxicity of allogeneic transplants. Our physicians are also researching the use of vaccine strategies to minimize post-transplant reactions and to replace high dose chemotherapy. An exciting approach in development involves inserting donor cells that are intentionally foreign and which would retain the ability to recognize and attack any residual tumors, while at the same time sensitizing the host cells to recognize any tumor as foreign. In other words, the host and donor cells will act in concert to destroy the cancer.

NewYork-Presbyterian/Columbia is being supported in its vaccine research by the Ludwig Institute for Cancer Research, an international organization that has 900 researchers throughout the world. The Cellular Immunotherapy Research Laboratory will pursue not only the vaccine strategy, but will also seek to develop monoclonal antibody therapy for cancer patients and to discover new small molecules that may hold the key to cancer therapy in the future.

Social workers conduct groups for patients, including a Bone Marrow Transplant (BMT) Orientation Group, which is a psychoeducational group providing support and information regarding the entire bone marrow transplant process, as well as a Post Transplant Peer Support Group.

Adult Bone Marrow And Blood Stem Cell Transplant Program Of NewYork- Presbyterian Hospital/Weill Cornell Medical Center

At NewYork-Presbyterian/Weill Cornell, patients benefit from advancements in allogeneic stem cell transplants and non-myeloablative allogeneic transplants. In 1999, the Bone Marrow and Blood Stem Cell Transplant Program received approval from the State of New York to perform allogeneic stem cell transplants. This was an important development for patients with hematologic malignancies who require allogeneic transplants. Until recently, unrelated donors were nearly impossible to identify, and only a handful of patients without an immunologically matched family member were able to undergo transplants. With the development of unrelated transplant donor registries, the Program now calls on a worldwide resource of bone marrow donors for patients with life-threatening forms of leukemia.

In addition, as a result of pioneering work at NewYork-Presbyterian/Weill Cornell in non-myeloablative allogeneic transplants ("mini" transplants involving lower doses of chemotherapy), older patients can undergo donor-type transplants with relative safety. In the past, few patients over the age of 50 could undergo these transplants because they were at unacceptably high risk for complications. These new approaches expand the availability of stem cell transplantation as a treatment for patients with non-Hodgkin's lymphomas, leukemia, multiple myeloma, as well as those with breast cancer, ovarian cancer, and Hodgkin's disease.

A national leader in the use of stem cells, NewYork-Presbyterian Cancer Centers have also played a central role in developing techniques to harvest and store stem cells. For this and other reasons, the Bone Marrow and Blood Stem Cell Transplant Program at NewYork-Presbyterian/Weill Cornell is experiencing dramatic growth, and has recently constructed a new 16-bed transplant unit that accommodates all types of transplant patients, but particularly allogeneic transplant patients.

Social workers dedicated to the Bone Marrow and Blood Cell Transplant Program provide psychosocial care, including preadmission services and a post-transplant support group, for patients and their families.