The Bone Marrow Transplant (BMT) Tandem meetings are the premier international conference on stem cell transplantation. Held in February 2017 in Orlando, Florida, the BMT Tandem Meetings serve as the combined annual meetings of the Center for International Blood & Marrow Transplant Research (CIBMTR) and the American Society for Blood and Marrow Transplantation (ASBMT). The CIBMTR and ASBMT are the two leading organizations for dedicated to advancing the field of bone marrow transplantation.
The 2017 BMT Tandem Meetings addressed the latest updates in hematopoietic cell transplantation related to research and patient care, and were attended by thousands of transplant physicians, pharmacists, research nurses, nurse practitioners, physician assistants and other transplant professionals. The Weill Cornell Medicine/NewYork-Presbyterian team was well represented at this year’s conference.
During the meeting, Dr. Tsiporah Shore presented data on an innovative bridge protocol for treatment of patients with recurrent lymphoma and partial or incomplete responses to salvage chemotherapy.
Such patients used to have a low cure rate after autologous transplantation. And many of them recurred again. Approximately two weeks prior to the transplant, we administered high doses of bendamustine. This agent is very well tolerated and very effective. It converted many partial responses into complete responses. Using our “bendamustine-bridge” approach, we have achieved an 80% long-term remission rate in this group of traditionally hard-to-treat patients.
Additionally, Dr. Jingmei Hsu presented data on allogeneic transplant for patients with lymphoma (non-Hodgkin and Hodgkin) and who don’t have matching donors. These patients are the most challenging to treat. This is because they have forms of the disease that are resistant to other treatments, often have already failed autologous transplant, have very high relapse rates, and high rates of graft-versus host disease (GVHD), as well as other complications. Using our haplo-cord approach – a transplant utilizing a related or unrelated donor with a different HLA type combined with an umbilical cord blood unit — we reported up to sixty percent long-term cure rates with minimal chronic GVHD.
Amritha Singh, a PharmD (pharmacist) in training at Weill Cornell Medicine and NewYork-Presbyterian Hospital, presented data on outcomes with two different schedules of post-transplant G-CSF administration.
G-CSF is a medication used to enhance recovery of white blood cells after transplant and thus decrease the risk of infection. But it requires painful injection, causes bony aches and is expensive. Here we showed that we could reduce the usage of G-CSF and thus reduce toxicity and costs, without affecting long-term outcomes.
Dr. Hannah Choe, a hematology/oncology fellow in our program, presented data on the management of transplant patients who have pre-formed antibodies against their grafts. These antibodies, often caused by prior pregnancy or blood transfusions, can delay engraftment – the period when the new stem cells start to grow and make healthy blood cells in the body.
We tested a number of interventions such as administration of the drugs rituximab or bortezomib and also a procedure called plasma-exchange. Each of these interventions had variable rates of success. The search for better treatments continues. When possible, we try to identify a donor against whom the patient has no antibodies.