(BPT) - "New blood" can revitalize a struggling business, whether it's a sports team on the wrong side of the wins and losses column or a retailer wondering where the customers went.
For some cancer patients, new blood is a literal lifesaver. Blood and bone marrow transplants, sometimes called stem cell transplants, offer a precious second chance to people with different types of blood cancers as well as sickle cell anemia and aplastic anemia, known as bone marrow failure.
Michelle Hudspeth, M.D., director of both the adult and pediatric Blood and Marrow Transplant (BMT) and Cellular Therapy program at the Medical University of South Carolina, said these transplants are occurring at a quickening pace at MUSC Health, demonstrating the expansion of treatment options that may benefit many.
"Our accelerated growth occurred despite the COVID pandemic, which created not only an extraordinary challenge to care for the most immune-compromised patients but also the most difficult time to access the international network for stem cell donors," Hudspeth said. "Our growth and outcomes are a true testament to the committed expertise and collaboration of our team."
A new start for patients
For patient Kennedy Golden, 23, the transplant is a new start.
Golden was working as a nurse at a hospital in Columbia, South Carolina, when she started having what she called "a year of tummy trouble." Doctors couldn't figure out the cause of her symptoms, until one day in October of 2023, she could barely walk.
She was admitted to the hospital, where she learned her bowel had ruptured. Doctors performed a biopsy, and she learned that she had intestinal T-cell lymphoma, a rare type of non-Hodgkin lymphoma, which prompted her oncologist in Columbia to refer her to Hollings Cancer Center at MUSC.
Hope at Hollings Cancer Center
At Hollings, Golden met with an experienced health care team who put her worries at ease. She had six rounds of chemotherapy in Columbia, from that November through March of 2024, as her treatment plan progressed toward the stem cell transplant. Through most of it, she continued to work.
Golden's transplant was autologous, meaning that it used her own stem cells instead of a donor's. To prepare for the transplant, healthy stem cells are removed from the patient. This can be done in the operating room by removing the cells directly from the bone marrow. However, today, the majority of transplants use peripheral blood stem cell retrieval instead.
In this procedure, the patient gets injections of a protein that prompts the stem cells to start moving out of the bone marrow into the bloodstream. From there, they can be retrieved in a process called apheresis. Blood is removed from a vein and run through a machine that separates the stem cells from everything else. The remaining blood is returned to the body.
The patient then undergoes high-dose chemotherapy that kills off any remaining cancer cells as well as the bone marrow. The peripheral blood stem cells are then infused into the patient, where they will take root, or engraft, and start producing new blood cells.
Outcomes to be proud of
Golden's treatment was successful, and she's grateful to the many teams that provided her expert care. She is just one of many who receive life-preserving cancer care at Hollings every year. In fact, the 2023 annual quality report published by the MUSC BMT and Cellular Therapy team shows that the program has grown in the past few years while maintaining survival rates above the national average. In 2023, 144 adults received stem cell transplants, compared with 95 in 2018.
And in keeping with MUSC's mission to bring high-quality care to all South Carolinians, the BMT team transplanted almost twice the percentage of underserved patients as the national composite, which Hudspeth said speaks to their mission of providing access and breaking down barriers.
Forging ahead with new cellular therapies
Every cancer patient is unique, so it follows that every treatment plan must be unique. Hollings has been a leader in BMT for decades - even making history in 1996 by performing the first outpatient matched unrelated transplant. Now at Hollings, half of autologous transplants are performed on an outpatient basis. Today, a large outpatient bone marrow transplant clinic is dedicated to these life-changing treatments.
Of course, not all patients can use their own stem cells, and Hollings is future-focused by offering options for those patients as well. MUSC was part of the original multi-center trial that changed the trajectory of transplants, making it possible for almost every patient to have a donor for transplant because an exact match was no longer necessary.
Hollings now routinely performs successful haploidentical stem cell transplants, also known as half-matched transplants. This transplant uses a donor's tissue, but rather than a full match to the patient's tissue type, it only requires a match at half of the HLA, or human leukocyte antigen, protein markers. This means more opportunities for matches, transplants and lives saved.
This is particularly meaningful for pediatric patients.
"In pediatrics, patients typically need more intensive chemotherapy and radiation for the best chance of cure. I helped to write the Pediatric Transplantation and Cellular Therapy Consortium multi-center pediatric trial using full-dose chemotherapy and radiation for pediatric patients with leukemia with half-matched family donors. This was nicknamed the 'maxi-haplo' trial," Hudspeth said. "This has also revolutionized the field and made it possible for almost all patients to have a donor for transplant and still be able to receive the highest levels of chemotherapy and radiation safely."
Positive performance and results
Results continue to be positive. A new report from the Center for International Blood and Marrow Transplant Research examining transplant centers that perform allogeneic transplants lists MUSC as one of 12 out of 172 that had outcomes better than expected during the evaluation years of 2020 through 2022. Even more impressive: The results were during the height of COVID, a time of logistical challenges as well as health challenges for this immunocompromised patient group.
Hollings is one of 73 National Cancer Institute-designated cancer centers in the nation and the only one in South Carolina. To learn more, visit HollingsCancerCenter.MUSC.edu.