Weill Cornell Bone Marrow Transplant Program


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Worldwide Network for Blood and Marrow Transplantation Workshop

Dr. Usama Gegis.pngOn January 15-17, 2017, the 4th Worldwide Network for Blood and Marrow Transplantation Workshop was held at the King Faisal Research and Cancer Center in Rhyadh, Saudi Arabia.

Dr. Usama Gergis of the Weill Cornell Medicine and NewYork-Presbyterian Bone Marrow Transplant Program served as session chair and moderator for a symposium on the long-term complications of bone marrow transplantation.


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Allogeneic Transplantation for Patients With Advanced Myelofibrosis: Splenomegaly and High Serum LDH are Adverse Risk Factors for Successful Engraftment

Myelofibrosis is an often aggressive form of myeloproliferative disease. Many patients benefit from medical therapy, but others are better served with a stem cell transplantation. Dr. Usama Gergis from our team recently reported the outcomes for 30 patients transplanted at our institution between 2000 and 2014. He showed that long term cure can be obtained, but that the risks are considerable, particularly in patients with massive splenomegaly.

http://www.sciencedirect.com/science/article/pii/S2152265016000598

These historical data are informative, but are unlikely to represent current outcomes.  Better supportive care and earlier referral have over the past years resulted in markedly improved outcomes.

 


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Haplo-Cord Transplant Outcomes Compared to Double Cord Blood Transplant

Many patients who need transplant do not have matching donors in the registry. They are commonly offered umbilical cord blood transplantation, where stem cells are isolated from the umbilical cord blood of newborns. Other centers use grafts from partially matched related donors, so-called haplo-identical transplants.

In a procedure largely developed at our center, we use a combination of haplo-identical and umbilical cord blood cells. In a paper recently published in the journal Haematologica, we show how haplo-cord transplants recipients have considerably better outcomes when compared with double cord transplant recipients.

Van Besien et al, Reduced intensity haplo plus single cord transplant compared to double cord transplant: improved engraftment and survival free of progression and GVHD (GRFS), Haematologica,  February 2016


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Treatment of Para-influenza Virus in Transplant Patients

Para-influenza virus is common in the community and can cause severe and sometimes life-threatening pneumonias.  Patel et al, tested the novel drug DAS181 in transplant patients with such infections an report encouraging outcomes.

Salvatore et al, DAS181 for Treatment of Parainfluenza Virus Infections in Hematopoietic Stem Cell Transplant Recipients at a Single Center, Biology of Blood and Marrow Transplantation, February 2016.


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Transplant for Follicular Lymphoma

Many new treatments have been developed for follicular lymphoma over the past years. But for some patients, autologous or allogeneic transplant remains the best option. Here Dr. van Besien discusses the pro’s and con’s of allogeneic vs autologous transplantation.

Allografting versus Autografting for Follicular Lymphoma: An Ongoing Conundrum, BBMT Volume 21, Issue 12, December 2015, Pages 2035–2036


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Presentations at ASBMT

The “Tandem Meetings” are the premier venue for presenting novel data in transplantation.

Held in Honolulu, Hawaii, our team was well represented;

Hanna Choe, MD, a fellow in Hematology/Oncology presented on a new transplant conditioning regimen. Fludarabine, Melphalan, 4Gy TBI Conditioning for High-Risk Haplo-Cord Transplantation Is Well Tolerated and Results in Prompt Engraftment

Jen Bourke, RN, BSN, OCN, our transplant coordinator, presented on  Extracorporeal Apheresis Via AV Fistula in Multiple Myeloma Patients with End Stage Renal Disease


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Subcutaneous Alemtuzumab

Alemtuzumab is commonly used in transplant conditioning to prevent graft vs host disease. It is very effective, but when given intravenously it often causes rigors, chills and fevers. Khilna Patel, Pharm D recently reported how Subcutaneous administration is much better tolerated with fewer side-effects, and is equally effective.

Comparison of Subcutaneous versus Intravenous Alemtuzumab for Graft-versus-Host Disease Prophylaxis with Fludarabine/Melphalan–Based Conditioning in Matched Unrelated Donor Allogeneic Stem Cell Transplantation, BBMT Volume 22, Issue 3, March 2016, Pages 456–461