Find A Physician

Return to Doctors Seek Ways To Expand Donor Pool for Blood Cancer Patients Overview

More on Doctors Seek Ways To Expand Donor Pool for Blood Cancer Patients

Newsroom

Return to Doctors Seek Ways To Expand Donor Pool for Blood Cancer Patients Overview

More on Doctors Seek Ways To Expand Donor Pool for Blood Cancer Patients

Research and Clinical Trials

Return to Doctors Seek Ways To Expand Donor Pool for Blood Cancer Patients Overview

More on Doctors Seek Ways To Expand Donor Pool for Blood Cancer Patients

Clinical Services

Return to Doctors Seek Ways To Expand Donor Pool for Blood Cancer Patients Overview

More on Doctors Seek Ways To Expand Donor Pool for Blood Cancer Patients

Doctors Seek Ways To Expand Donor Pool for Blood Cancer Patients

NEW YORK (Jun 3, 2013)

For patients diagnosed with serious blood diseases such as lymphoma, multiple myeloma, or leukemia, bone marrow or blood stem cell transplants provide a life-saving treatment. The procedure entails replacing the patient's diseased bone marrow with bone marrow containing healthy stem cells, thereby rebuilding the patient's blood cells and immune system.

Markus Y. Mapara, M.D., Ph.D.
Markus Y. Mapara, M.D.,
Ph.D.

Estimates indicate that 30% of patients who need a bone marrow transplant have a matching donor in their family, while the remaining 70% must search for a compatible donor in the national and international registries. The odds of finding a match in these registries are about 70% for Caucasians, but lower among ethnic minority patients who are underrepresented in the donor banks.

As the demand for bone marrow transplants rises, experts seek new ways to expand the donor pool. For patients who are unable to find a perfectly matched donor, doctors at NewYork-Presbyterian are helping to expand the donor pool by performing haploidentical (mismatched related donor) and cord blood (umbilical cord blood collected after a baby is born) transplants.

Koen van Besien, M.D., Ph.D.
Koen van Besien, M.D.,
Ph.D.

"The attraction with haploidentical transplants is that everybody potentially has a haploidentical donor because everyone has a parent or sibling who is only partially matched," said Markus Y. Mapara, M.D., Ph.D., Director of the Blood and Marrow Transplantation Program at NewYork-Presbyterian/Columbia University Medical Center. "From a logistical standpoint, haploidentical transplants are easier to perform and not as expensive because you don't need to buy the cord blood," he said.

Doctors at NYP are currently performing allogeneic (donated bone marrow) matched transplants to make sure things are working according to plan. "Transplants are safest when the donor and recipient are closely matched," said Dr. Mapara. "The more the donor and recipient differ, the higher the risk for complications including graft versus host reaction – where the donor cells recognize the recipient as foreign, and attack the recipient's tissue." Dr. Mapara's group is planning to perform their first haploidentical transplant in the latter part of 2013 when construction on the new bone marrow transplant unit at NYP/Columbia is complete.

Although Dr. Mapara sees the graft versus host reaction as a major challenge, he also sees it as an opportunity. To this end, he is studying ways to steer the response by manipulating the graft with regulatory T-cells. His group is interested in using these cells in combination with haploidentical transplants. "Regulatory T-cells have been shown to effectively suppress the graft versus host disease without mitigating the anti-tumor effect," he said. By implementing this dual-focused approach, Dr. Mapara hopes to make mismatched transplants safer and more feasible for patients.

To further expand the donor pool, Koen van Besien, M.D., Ph.D., Director of Stem Cell Transplant at NewYork-Presbyterian/Weill Cornell Medical Center, is spearheading a combined haploidentical and cord blood transplant approach. His group has seen positive results and believes the combined "haplo" and cord blood transplant joins the best of both procedures.

"Patients who undergo a haplo-cord transplant exhibit faster recovery and are able to avoid early low blood counts because of the rapid recovery of the haploidentical graft. Over time the haploidentical graft is replaced by the umbilical cord blood graft which recovers more slowly, but shows lower rates of relapse and graft versus host disease," said Dr. van Besien.

His group has performed 20 grafts in the last 6 months using a combined haplo and cord blood transplant procedure. "The combined approach is quite promising – we gave gotten excellent results with mismatched donors. We are now able to identify donors for the majority of our patients. However, the field is changing so rapidly that there is always room for improvement," said Dr. van Besien.

In addition to expanding the donor pool by performing haploidentical and cord blood transplants, doctors at NYP encourage the public to become bone marrow donors. "Donor runs and mobilizing the public to donate are critical. This is especially important in ethnic minority populations," concluded Dr. Mapara.

  • Bookmark
  • Print

    Find a Doctor

Click the button above or call
1 877 NYP WELL


eNewsletters
Top of page