By Dean S. McGaughey, III, MD
Virginia Oncology Associates

 

Some patients may be confused by the term ‘stem cell transplant,’ but they should be assured it’s the same methodology as the bone marrow transplant they’re familiar with.  The change in the procedure, and the reason for the change in terminology, is that we’re no longer transplanting the bone marrow itself.  For patients with relapsing lymphoma and multiple myeloma, who required massive doses of chemotherapy, the change has been dramatic.

Prior to the year 2000, the only way to retrieve stem cells from these patients was to take them to the OR and do a bone marrow harvest, which involved poking as many as three hundred holes in the pelvis to extract bone marrow. Depending on the patient, recovery could take several days to weeks of back, hip and/or muscle pain with bruising.  In 2000, oncologists discovered a far easier method to collect the necessary stem cells for the transplant that eliminates the needle sticks.

Now we can “mobilize stem cells” by giving a moderate dose of chemo, followed by several days of neupogen, a combination that will temporarily push the stem cells out of the bone marrow into the blood stream.  When blood tests reveal an adequate number of stem cells, we collect them through apheresis. We can then freeze these stem cells just as we did the bone marrow.  We are then ready to do the autologous stem cell transplant, which involves large dose chemotherapy, followed by stem cell reinfusion.

Thus, autologous transplant lets us give larger doses of chemotherapy than otherwise possible.

Both internationally and locally, the cure rate for relapsed lymphoma patients has doubled, from 20 to 40 percent with the use of transplant.  Stem cell transplant has also significantly improved the survival of myeloma patients, versus standard therapy alone.

Stem cell apheresis transplantation is now the standard of care for patients with advanced myeloma and relapsed lymphomas.  In addition to Hampton Roads, there are currently three centers that offer the treatment in Virginia, making it available throughout the Commonwealth.

Dr. McGaughey received his medical degree from the University of Chicago, Pritzker School of Medicine. He completed both his residency in Internal Medicine and his fellowship in Hematology and Medical Oncology at Duke University Medical Center in Durham, North Carolina.  He is currently Director of the Stem Cell Transplant Program at Virginia Oncology Associates.  www.virginiacancer.com