Physicians have performed approximately 1 million stem cell transplants since the procedure was first tried more than 70 years ago.
Dana-Farber, which has one of the largest and most successful stem cell transplant programs in the country, has performed more than 11,800 transplants in its 50-year history. Over that span, one-year survival rates have improved substantially, placing Dana-Farber among the best in the world – despite taking on some of the more challenging cases.
Dana-Farber’s clinical achievements and basic scientific discoveries have helped advance the transplant field. A cadre of Dana-Farber physician scientists has spent decades working to understand the biology underlying transplant success and failure, and harnessing those findings to improve the clinical outcomes of patients.
“It’s so much easier on patients and so much better,” says Joseph Antin, MD, chief of stem cell transplantation emeritus. “It was very stressful, very demanding, with long hospital stays. We can do an outpatient allogenic transplant now that in 1981 would have required a three-month hospital stay.”
The Dana-Farber transplant program began in the early 1980s and initially focused on autologous transplants, in which a patient’s own stem cells are harvested and then returned after the patient receives treatment to eradicate the cancer. This was one of the first autologous transplant programs in the country.
However, in patients with acute lymphoblastic leukemia (ALL), autologous bone marrow harvests could contain small numbers of leukemia cells that could lead to relapse when infused back into the patients. A preventive approach emerged from the Dana-Farber laboratory of Jerome Ritz, MD, which had developed monoclonal antibodies that could distinguish ALL cells from normal hematopoietic stem cells. These antibodies were used to purge any residual ALL cells from the patient’s harvested cells prior to reinfusion.
Similar approaches were developed for patients with relapsed B cell lymphoma, myeloma, and acute myeloid leukemia (AML) using antibodies developed at Dana-Farber.
Prior to the year 2000, the one-year survival rate for step cell transplants was 56–58%.
Today one-year survival rates are 75–76% (based on 2021 Transplant Center-Specific Survival Report from the Center for International Blood and Marrow Transplant Research for unrelated and related donor stem cell transplants)
This approach also improved the results of allogenic stem cell transplants, in which stem cells are harvested from a donor. In patients undergoing allogeneic stem cell transplants, the donor’s T cells can attack the recipient’s tissue, leading to graft versus host disease (GFHD). Ritz began to use an antibody developed at Dana-Farber to purge T cells from normal donor marrow to prevent GVHD after transplant. Clinical trials led by Robert Soiffer, MD, showed a very low incidence of acute and chronic GVHD after transplant with this technique.
Ever since the early days of the program, says Arnold Freedman, MD, an Institute physician who specializes in lymphomas, “we had a large number of physician-scientists doing groundbreaking work in human immunology, but they also had a clinical interest. They asked, ‘how can we apply what we’re doing in the laboratory to human disease, and make a difference by doing that?'”
As a result, by any measure, patients do much better today than in the past.
To learn more about Dana-Farber’s pioneering work in stem cell transplants and its leadership in treating all hematologic malignancies, click here.
For additional information about Dana-Farber for healthcare professionals, click here.
