The MUSC Hollings Cancer Center has performed autologous and allogeneic blood and marrow transplants (BMT) since 1987, and was the first program of its kind in the state. The program is active in marrow donor recruitment and is a member of the International Bone Marrow Transplant Registry, the National Marrow Program and the Cancer and Leukemia Group B (CALGB). Involvement in these organizations means that the MUSC program can tap into a tremendous reservoir of data, transplant registrants, case information and research protocols from specialist worldwide. MUSC developed an outpatient blood and marrow transplant program that has resulted in less time in the hospital, virtual elimination of the need for a sterile environment, and a 30 to 50 percent reduction in charges. By condensing the patient’s treatment to daytime hours at the MUSC Hollings Cancer Center treatment suite, the patient and a caregiver, usually a family member, are able to stay at a nearby facility. Although it is not appropriate for all patients, this innovative program allows patients to feel less isolated and more in control of their lives. BMT is the most promising curative therapy for a broad range of illnesses including:
• AML. CML. ALL. CLL
• Non-Hodgkin’s lymphoma
• Hodgkin’s disease
• Inherited diseases The MUSC BMT program is involved in promising new protocols for patients undergoing autologous and allogeneic treatment therapy including: • Mini-dose transplant protocol – Used with immunotherapy to help reduce the risk and problems associated with chemotherapy toxicity • Dose escalation protocol – Used to study the efficacy and toxicity of the inhibition of topoisomerase I and II. The goal is to inhibit the tumor’s resistance to chemotherapy • Auto-immune disease protocol – A new regimen combining t-cell depletion and immunotherapy to change the immune system of the patient with systemic diseases such as scleroderma, systemic lupus erythematosus (SLE) and inflammatory myopathy Blood and marrow transplant therapy takes approximately one month for autologous and three for allogeneic procedures. Post transplant follow-up involves close monitoring by the MUSC Blood and Marrow Transplant team and the patient’s referring physician. Blood and Marrow Transplantation for Children
Blood and marrow transplantation is curative for children with marrow disorders such as aplastic anemia, and offers a significant chance of cure for those with high risk or relapsed leukemias. Recently, the use of autologous peripheral blood stem cells following high-dose chemotherapy has been effective in the treatment of advanced stage neuroblastoma. Blood and marrow transplantation offers the only chance of cure and has been very effective in children with severe sickle cell disease. MUSC has a very active pediatric bone marrow and peripheral blood stem cell transplantation program. Since the first pediatric bone marrow transplant was performed 1990, a large number of children with both malignant and non-malignant conditions has received transplantation. The sources of stem cells include matched sibling marrow, unrelated marrow and cord blood, as well as autologous peripheral blood stem cells.
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