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How Does Stem Cell Transplant Work?

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Published on January 9, 2017

MPN expert, Dr. Srdan Verstovsek, of the University of Texas MD Anderson Cancer Center discusses how stem cell transplant works and the effect on the body. Dr. Verstovsek states “bone marrow transplant is the only way at the moment that we can use to cure people from myeloproliferative neoplasms." In addition, Dr. Verstovsek also addresses how realistic it is that we will see a cure for MPNs.

This town meeting was sponsored by the Patient Empowerment Network, which received an educational grant from Incyte Corporation. It was produced by Patient Power in partnership with The University of Texas MD Anderson Cancer Center. 

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Transcript | How Does Stem Cell Transplant Work?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That's how you’ll get care that's most appropriate for you.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Jeff Folloder:

I’ve got a question for Dr. V from one of the people in the audience. That’s a great question about something that we really didn’t touch on much. They wanted to know about stem cell transplants and the whole mechanics and how and why behind them. When are they called for? And exactly what is it that they do to the body’s genes?

Dr. Verstovsek: 

This is really important, in fact, because the bone marrow transplant is the only way at the moment that we can use to cure people from myeloproliferative neoplasms. Now, it’s a not easy procedure. It can affect the person directly and because it’s so aggressive procedure, and I’ll explain that. We don’t utilize it in patients with ET or PV and not even with all the patients with myelofibrosis. But we do look at the risk of myelofibrosis affecting the life expectancy of the patient. There are certain diagnostic factors from the history that we can utilize to identify patients that possibly have shorter life expectancy than the others. And in that case—if that’s the case and the patient is younger and fit, and there is a done for a bone marrow transplant, then we advise patients to go through the bone marrow transplant procedure.

The procedure on its own is relatively simple. You have a donor that has the cells that would be compatible with the cells of the recipient of the patient. You give a patient intensive chemotherapy, that means chemicals through IV that go all around the body and kills cells, and blood, and bone marrow, in the spleen as well, wherever they are. So you make empty space, and then you infuse the cells from somebody else. You can obtain cells from a donor by poking the donor in the back in the bones and sucking out the cells from the bone marrow, or there are techniques to devise from the blood of the donor.

But, basically, it’s an infusion, like a blood infusion or platelet infusion. It’s infusion of the cells from a person that you then receive and that’s—those cells go in the empty space. So your cells are gone—no more bad cells there. That’s the whole concept. 

You eliminate the cells with the chemotherapy, and then you infuse the new cells that would—if there is any leftover, kill those cells that are still there for good. And then you would have a different cells—a donor cells in your blood and bone marrow. That’s what the transplant is all about. And then there is no disease, there is nothing to worry about it. 

But it’s not that simple, because the chemotherapy can affect the patient. So you need to be younger and fitter. The cells from the donor may not take. They are infused in empty space, but they do not take, and the disease just comes back. Or they can attack the body of the patient itself as a foreign body. Or the disease may come back some years down the road despite all the efforts. So one needs to be very careful in deciding on the transplant, the timing, and who is the proper patient. It’s the whole science behind it, because as we go through time, the changes in the procedure that they make to improve it all the time.

So it’s difficult to say what to expect with another approach if you just compare yourself to 10 or 20 years ago. It’s not the same anymore. We make progress all the time.

Jeff Folloder:     

Just as a follow-up question, you mentioned a four letter word when you first started speaking. You said the cure word. Is that realistic for MPNs?

Dr. Verstovsek: 

This is our goal. Any attempt that we have in developing new medications or with the current medications is to do the best we can, the best would be to cure people. With medications that we have, infuriately that does not happen. There are exceptions, and you find those exceptions published in scientific literature like one case here and once case there. But, by and large, the therapies that we have are here to control the disease, signs and symptoms, or prevent progression so that you live with the disease the best way possible, with an excellent quality of life for as long as possible. 

We are looking for a cure with new medications. We talk about medical studies. Some of those may provide, in some patients, ability to eliminate disease. But cure is really hard and more realistically at this time is control of the disease and make it as chronic as possible, so it does not affect your life expectancy at all. If I can achieve that in my lifetime, that would be great. But I do aim for cure like you do. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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