60 Years of Blood and Marrow Transplants
Education & Research Today, nearly every patient with a cancer curable by allogeneic bone marrow transplant will find a donor. Here’s how we got here, and what appears to be on the horizon.
2017 marks the 60th anniversary of the first bone marrow transplant. Dr. E. Donnall Thomas, winner of the 1990 Nobel Prize in Physiology or Medicine, first began to transplant bone marrow stem cells into patients with blood cancers in 1957.
The first decade
The early days were difficult for Dr. Thomas and his patients, and for the first decade there were few successes. However, through his persistence and efforts, Dr. Thomas refined his approach, which then consisted of giving high doses of chemotherapy and radiation to patients, followed by infusions of bone marrow from family donors.
Over a decade later in 1968, transplant teams at the University of Minnesota and elsewhere first saw lasting cures of immune deficiency diseases and cancers, due to successful bone marrow transplants. In the following three decades, many more scientific and clinical successes followed, leading to the demonstration of the utility of bone marrow transplants (BMT) for a wide range of blood, bone marrow and lymph node cancers.
The big advances
In the 1960s, bone marrow was the only source of stem cells and the process of transplantation was very risky, with few patients surviving. Since then, profound advances in stem cell collection, donor matching and clinical care have dramatically improved outcomes for a broad range of diseases.
These days, many patients have stem cells collected from their blood and only a minority of patients have life-threatening complications while hospitalized. BMT physicians were also among the first to recognize that donor transplants are also a form of immune therapy, capable of curing diseases incurable by chemotherapy alone.
“Research shows that physicians who refer patients for transplant can greatly influence survival rates...”
Present and future directions
The intensity of chemotherapy for most patients is less intense than the early days, and many patients (including those who are older and with other active medical conditions) have a relatively uncomplicated and comfortable course. Over the past two decades, transplant physicians have also learned how to harness immune cells — from donors or from the patient — to treat cancers, either with or independent of a BMT.
What patients should know
Unfortunately, not enough blood cancer patients consider blood and marrow transplants earlier in their care. Research shows that physicians who refer patients for transplant can greatly influence survival rates by referring patients for consultation early when transplant will be most effective, and by recognizing post-transplant complications early, while therapeutic options are more effective.
The partnership between physicians who refer for transplant and those who treat patients with transplant has been integral in the improved outcomes seen in transplantation. Blood cancer patients should discuss BMT with their primary oncologists and hematologists, and consider obtaining a consultation with a transplant expert to determine their best options.