Carlos R. Bachier, MD
Even with recent significant advances in the treatment of hematologic malignancies, such as chimeric antigen receptor (CAR) T-cell therapy, investigators are still focused on improving one of the field’s longest-established therapies—stem cell transplant.
State of the Science Summit™ on Hematologic Malignancies, Bachier, program director of Sarah Cannon Center for Blood Cancer, Sarah Cannon Research Institute, discussed the evolution of stem cell transplantation as a treatment for patients with hematologic malignancies.
OncLive: Please discuss the evolution of stem cell transplants.
There has been an evolution in the way that we treat transplant patients. Forty or 50 years ago, we started just using bone marrow as the source of stem cells. Now, we can obtain stem cells from the peripheral blood. This has benefited patients in the autologous setting, where the recovery of blood counts is much faster. It is the same in the allogeneic setting, where we use donors.
mutations. What we have learned is that if you give midostaurin to patients prior to transplant, their outcome after transplant will be much better. We have had the beneficial influence of these new drugs, which have made transplant much better.
Can you address some of the common toxicities that patients may experience following stem cell transplant?
It is mostly related to toxicities in the allogeneic transplant setting. Patients receive a transplant through donors, and while these donors are immunologically similar to the recipient, there are still differences between them. When the cells are infused into the recipient, the immune cells may think, "What am I doing here? This is not my body.” They will then attack the recipient’s body. If that happens, patients will develop a complication called GVHD. This is one of the most serious complications that a patient can have after transplant. We have been looking at developing new therapies that can effectively prevent and treat GVHD, although it is still a problem that we face.
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