Blood Cancer Care

Our center has a comprehensive approach to treat patients: from diagnosis through treatment, into remission, followed by stem cell transplantation and then follow up care as a cancer survivor.

Each patient is supported by a team that includes nurse practitioners, inpatient nurses, nurse navigators, social workers, oncology pharmacists, stem cell collection (apheresis) staff, and stem cell processing staff. The team also includes specialized laboratory staff for DNA tests, like HLA typing.

The Georgia Cancer Center at Augusta University has the region’s only Blood & Marrow Transplant and Cellular Therapy (BMT&CT) program to treat adult leukemia, lymphomas, multiple myeloma, and other types of blood cancers and disorders.

Our BMT&CT multidisciplinary team includes transplant-trained physicians, nurse practitioners, inpatient nurses, transplant coordinators, nurse navigators, social workers, oncology pharmacists, stem cell collection (apheresis) staff, financial coordinator, and stem cell collection & processing staff. The team also includes specialized laboratory staff for DNA tests, such as Human Leukocyte Antigen (HLA) typing.

Comprehensive Care

We provide a comprehensive treatment program that includes prompt access to consultation or second opinion for all hematologic malignancies, as well as access to the Georgia Cancer Center or Cooperative Group Clinical Trials.

Fighting Blood Cancer Together 

We are one of only three adult BMT programs in Georgia accredited by both the Foundation for the Accreditation of Cellular Therapy (FACT) for Autologous and Allogeneic transplants and cell processing and the National Marrow Donor Program (NMDP).

Conditions we treat:

• Leukemia
• Lymphomas
• Multiple Myeloma
• Aplastic Anemia
• Amyloidosis
• Myelodysplastic Syndrome
• Myelofibrosis

Transplant Therapies We Offer

Our Blood & Marrow Transplantation and Cellular Therapy Program (BMT&CT) includes these life-saving alternatives:

• Autologous stem cell transplant uses a patient’s own stem cells; you may hear your care team refer to this as an “auto transplant".
• Allogeneic stem cell transplant uses healthy stem cells from a matched relative or matched unrelated donor; you may hear your care team refer to this as an “allo  transplant".

• CAR-T cell therapy. As a part of cellular therapy, our BMT&CT program offers the FDA approved Chimeric Antigen Receptor–T (CAR-T) cell therapy . CAR-T cell therapy is a cancer immunotherapy treatment that uses genetically engineered T cells to trigger a patient's immune system to identify and destroy certain cancer cells.
  
  CAR-T cell therapy is not a first line of treatment for cancer and it is not the same or substitute for the bone marrow transplant. Only some types of leukemia and lymphoma can be treated with CAR-T. Please contact us to find out more about the options for CAR-T cell therapy.

What to Expect

The process of a bone marrow/stem cell transplant can be long and difficult, but patients benefit from the support of a dedicated multidisciplinary care team who are there to answer your questions before, during and after your procedure.

The bone marrow and stem cell transplant process includes:

• Evaluation and preparation: Before transplant, the Blood & Marrow Transplant (BMT) team will need to determine that you are healthy enough for the transplant. Patients complete medical tests, including bone marrow biopsy, heart tests, blood and lung studies, along with consultation with the transplant team, including a psychological evaluation.
• Collection: Depending on the type of transplant one is undergoing (Autologous or Allogeneic), stem cells will be collected either from the patient (also referred to as the recipient) or from a matched donor. The Georgia Cancer Center works with the National Marrow Donor Program (NMDP), who provides excellent patient and family education
• Conditioning: Patients are treated with high doses of chemotherapy and/or radiation to destroy cancer cells and ready the body for transplant.
• Infusion: Bone marrow/stem cells are infused through an IV, similar to a blood transfusion. 
• Recovery: Over the course of 2 to 6 weeks, transplanted bone marrow/stem cells engraft. Engraftment is when the donated cells you received for your transplant start to grow and make new blood cells in your body. During this time, your doctor will monitor your blood counts closely and may prescribe antibiotics and other medications.  
• Follow up: Your transplant team will remain in contact with you for the next year or more to provide medical follow-up and supportive care.

Stem cells from blood, not bone

Collecting stem cells from bone marrow by puncturing bone was more common in the past (called a bone marrow transplant), now most of the stem cells are collected from blood (called a peripheral blood stem cell transplant, or PBSCT). These stem cells produce the key components of blood: red cells that carry oxygen, white cells that are part of the body's immune response, and platelets that cause clotting.

You may receive chemotherapy or radiation to prepare for the stem cell transplant. This is also called the preparative or conditioning regimen.

Non-surgical transplant procedure

Some people may think a stem cell transplant is a surgical procedure, but it is more like a blood infusion. During a transplant, healthy stem cells are given to the patient through a central line (similar to an IV) that is placed in a large vein, usually in the neck or chest. It usually takes a few hours, and patients can read or relax during this procedure.

Support Services

The treatment plan may include several therapies and support services selected for specific care needs, which will become the multidisciplinary team. Some of these services may include:

• Stem cell transplantation
• Chemotherapy, radiation or drug therapies
• Clinical trials
• Image Boutique, offering supplies to help survivors look and feel their best
• Integrative therapies, including music therapy, chair yoga, and other support programs
• Mental and spiritual health counseling
• Symptom management

 

 Autologous stem cell transplants refer to stem cells that are collected from a patient and given back to that same individual.  Autologous transplants are by far the most common type of transplant performed in myeloma patients today. With this type of transplant, the patient's stem cells are obtained prior to high-dose chemotherapy, frozen, and stored if necessary, and are then given back to the patient after high-dose of chemotherapy.

Who is a Candidate Autologous Stem Cell Transplants?

High-dose chemotherapy accompanied by autologous stem cell transplant are considered by many to be a standard of care for healthy patients. It is a treatment option for patients with newly diagnosed disease and for those who have already received other treatments. In general, patients with good performance status, adequate kidney function and minimal comorbidity are eligible.

Advantages of autologous stem cell transplant

• The patient serves as his or her own source of stem cells: there is no need to find a donor and there is no risk of incompatibility.

• Autologous transplants are relatively safe procedures: low rates of complications and infections compared with Allogeneic transplants.
• In some instances, much of the procedure can be done on an outpatient basis.

Challenges

Autologous transplants may not be an option for some patients. In certain instances, prior treatment with certain chemotherapy drugs or with radiation therapy to the spine or pelvis may reduce the number of stem cells that can be collected for an Autologous transplant.

Allogeneic hematopoietic stem cell transplants use donor stem cells to restore a patient’s marrow and blood cells. Allogeneic transplants are a treatment option for Hodgkin’s lymphoma, acute myelogenous leukemia, acute lymphoblastic leukemia, chronic myelogenous leukemia, chronic lymphocytic leukemia, aplastic anemia and myeloproliferative disease.

 There are several ways donor stem cells can be obtained for this type of transplant:

• Matched related (siblings) donor
• Matched unrelated donor or cord blood
• Haploidentical (half matched related donor) transplant

The donor will have an evaluation for eligibility; if eligible, their stem cells will most likely to be collected from peripheral blood process. Once collected, the stem cells are frozen until used for the patient’s Allogeneic stem cell transplant.

National Marrow Donor Program (NMDP)

In the event a patient needs an allogeneic transplant and does not have a matched sibling, we get the matched unrelated donor or cord blood by searching international registry of NMDP, Be the Match.

Our multidisciplinary team includes a Human Leukocyte Antigen (HLA) Lab, which is vital for matching a patient to potential donors.

Who is a candidate for allogeneic stem cell transplants

In general, patients with good performance status, adequate kidney function, and minimal comorbidity are eligible. The donor must also be in good health and meet blood donor standards.

High-dose chemotherapy accompanied by allogeneic hematopoietic stem cell transplant is a treatment option for patients with newly-diagnosed disease and for those who have already received other treatments. Allogeneic transplant is primarily performed for patients with Leukemia.

Advantages of allogeneic stem cell transplant

• The Allogeneic transplant recipient may achieve complete remission of the disease (blood cancer) following this type of transplant.
• Measures are taken to prevent GVHD complications following these transplants.

Challenges

• Finding a suitable donor can be difficult.
• Managing post-transplant graft versus host diseases (GVHD).