Blood and Marrow Transplant Program

About the Blood and Marrow Transplant Program

If you have been diagnosed with leukemia, aplastic anemia, lymphoma or another type of cancer, you may be a candidate for a bone marrow or hematopoietic stem cell transplantation (HSCT). Years ago, such transplants were almost all performed using bone marrow. More recently, the field has largely shifted to obtaining the cells needed for transplant from the blood.

The Kimmel Cancer Center at Jefferson is home to Jefferson's Blood and Marrow Transplant (BMT) Program. Patients can be treated with HSCT using matched related donors, half-matched related donors or compatible unrelated donors.

There are eight research-driven transplant regimens, using both full intensity and reduced intensity chemoradiotherapy, designed to treat patients in varying stages of disease. This Program is accredited by the Foundation for Accreditation and Cellular Therapy (FACT), an international organization that sets quality standards for all aspects of transplant care.

A major part of many of the transplant treatment regimens is total body irradiation (TBI), which helps treat malignancy and facilitates the acceptance of donor cells. This radiation is provided at the Bodine Center for Radiation Therapy, one of the region's busiest radiation oncology centers, offering one of the largest cancer treatment programs in the Delaware Valley.

Our physicians are committed to providing you with thorough and compassionate care prior to, during and after your bone marrow transplant procedure. As with any organ transplant, a proper donor must be found first. Once a donor has been identified, you will be prepped for the procedure.

Preparations for a bone marrow transplant vary depending on:

• The type of transplant
• The disease requiring transplant
• Your tolerance for certain medications

BMT Outcomes

In 2005, a novel two-step method of stem cell transplantation was developed by the Jefferson Transplant team for patients who have only half-matched donors in order to decrease the severity of graft-versus-host disease (GVHD), an often life-threatening complication of stem cell transplant. In this approach, donor T-cells and stem cells are given in two separate steps. Chemotherapy drugs are administered after the introduction of T-cells but before stem cells are infused.

GVHD cells are killed while cells that restore normal bone marrow function are spared. This method has greatly improved the outcomes for patients undergoing transplants from half-matched donors allowing many more patients without matched donors to receive transplants. Because of the low treatment-associated complications using this approach, the two-step transplant process has been extended to patients with matched related donors and patients with sickle cell disease. This approach is especially effective for patients whose disease is under control at the time of transplant.

Our team has extensive experience and expertise in using mismatched donors for BMT, having now performed more than 120 transplants using this new approach. The outcome of our half-matched approach for patients transplanted in first or second remission now rivals the results seen with fully matched donors. We have applied similar approaches to most of our allogeneic (donor) transplants including our fully matched related and unrelated donor transplants and are also encouraged by our successes in these areas as well.

In some cases, transplants using your own cells (autologous transplants) are appropriate. This is also within the range of services that we provide.

Your Blood and Marrow Transplant Team

The BMT team at Jefferson is highly skilled and known for excellence in providing compassionate and state-of-the-art care to meet your needs as a bone marrow transplant patient. Our inpatient unit has been recognized for providing some of the highest levels of patient satisfaction. Throughout the course of your care, your BMT team is committed to offering you the most comprehensive care and a multidisciplinary approach to your treatment.

Team members consist physicians, nurses, coordinators, social workers, dieticians, pharmacists, physical therapists and others, depending upon your specific needs. Team members work and coordinate with each other to make sure that your bone marrow transplant goes smoothly and that you have a speedy recovery.