The RPCI BMT program emphasizes clinical trial development from investigator-initiated as well as cooperative group trials. All patients are transplanted on clinical trials. The program continues to emphasize excellence in clinical care and patient outcomes.
Radiation therapy is a critical component of the BMT program. Selected patients receive total body irradiation as part of the conditioning or preparative regimen before transplant. The Radiation Oncology department designs individual lung shields for each patient so as to minimize lung toxicity during the transplant. All BMT patients receive lung shielding and attention to minimizing side-effects of the radiation treatment.
Patients may also receive radiation to sites of cancer involvement before or after the BMT process.
Chemotherapy and Biological Therapy: The BMT program allows for the delivery of escalated doses of chemotherapy to allow for higher tumor killing. This principle is especially true during autologous BMT. The stem cell rescue prevents an extended period of marrow suppression (low blood counts). Allogeneic BMT relies more heavily on the immune capabilities of the donor cells. The donor cells attack the patient’s cancer and decrease the risk of relapse of the cancer.
The BMT program is evaluating new ways to increase blood stem cell yield during stem cell collection (leukopheresis).
There is a reduced-intensity transplant program that offers allogeneic BMT to patients who would not be good candidates for full-intensity therapy.
We are developing a model for selective T cell depletion of donor cells during the allogeneic BMT process. T cells can cause Graft-versus-Host disease (GVHD) and by removing some of these cells, we may be able to decrease the intensity of GVHD but preserve the graft-versus-tumor effect.