Since its first procedure in January 1994, the Tulane Stem Cell Transplant Program has become the premiere treatment center in Louisiana and Mississippi. And the program is still growing, says Hana Safah, director. Patient volume has increased by 60 percent over the past year.
The Tulane Stem Cell Transplant Program, led by Dr. Hana Safah, is developing new, life-saving options for leukemia patients. (Photo by Paula Burch-Celentano)
Tulane doctors perform transplants for adults and children — both autologous (stem cells harvested from the patient) and allogeneic (stem cells harvested from a matched donor, related or unrelated) transplants. It is the only source in Louisiana for matched unrelated donor transplants for adults, Safah says.
The program’s team is expanding research to find ways to reduce the risks, mortality and morbidity associated with mismatch transplants, particularly in leukemia patients.
“Ideally, a stem cell transplant donor and recipient are a perfect match, which means 10 out of 10 markers on the surface of their cells match up perfectly,” says Safah. “Anything less is called a mismatch.”
The possibility of a perfectly matched allogeneic transplant is limited by genetic restrictions. Within a family, full siblings have a one in four chance of matching each other perfectly. And perfectly matched unrelated donors are scarce — approximately 1 in 10,000 — even with the large international donor registry.
Research efforts at Tulane are aimed at increasing safety and decreasing risks associated with less rigid matching criteria. Mismatched transplants can have higher risk for complications.
“What we’re trying to do is develop ways to be more aggressive and accept the nine out of 10 patients who were previously considered too risky for treatment,” says Dr. Zachariah McIver, the transplant team’s newest member.
“Prior to transplant, we normally give chemotherapy conditioning to the patient in order to knock down his or her immune system so that the immune cells in the incoming graft can come in and take over,” McIver says. Rejection takes place when the immune system of the recipient fights back and kicks out the new tissue. “It’s like Star Wars, literally a battle between two armies.”
Melanie Cross is manager of communications at the Tulane Cancer Center.