News Article | December 5, 2016
PORTLAND, OR - New research shows that quickly identifying patients with high-risk acute myeloid leukemia (AML), and speeding the process to find them a stem cell donor and performing the transplant earlier, can significantly improve their chances of surviving for at least two years after diagnosis without a relapse. The research was conducted by SWOG, the cancer clinical trials group that is part of the National Cancer Institute's (NCI) National Clinical Trials Network, the oldest and largest cancer research network in the nation. Results will be presented Monday, Dec. 5 at the 58th American Society of Hematology Annual Meeting by Dr. John Pagel, chief of the Hematologic Malignancies program at the Swedish Cancer Institute in Seattle, WA and co-principal investigator for the SWOG research study, called S1203. Pagel's presentation is one of 18 made by SWOG investigators at the 2016 ASH annual meeting, held in San Diego, CA. "We are very excited to share these results," Pagel said. "This study showed we can get significantly more high-risk AML patients to a stem cell transplant before their cancer recurs by simply working hard to identify an appropriate donor and proceeding to transplantation as soon as possible. When we do, more high-risk patients live longer and are likely cured. This process may establish a new standard of care." AML is a fast-growing type of cancer, common in the elderly, in which the bone marrow makes too many white blood cells. According to NCI statistics, there will be an estimated 19,950 new cases of AML in 2016, with an estimated 10,430 deaths, in the United States. Only 27 percent of AML patients survive five years after their diagnosis, NCI data shows. Some are at even greater risk. High-risk AML marked by certain genetic mutations is more resistant to chemotherapy, and even if it responds to chemotherapy, can more quickly cause relapse and death. These high-risk patients are the population that Pagel and his team wanted to help when they designed and launched S1203. Previous research had shown that high-risk AML patients can live longer if they use a donor's stem cells to get an allogeneic hematopoietic cell transplant, or allogeneic HCT, after chemotherapy and before a relapse. But only about 40 percent of these high-risk patients do so. An allogeneic HCT is a complicated process of transplanting a type of stem cell from healthy donors, or in select cases, from cord blood, to patients with certain cancers of the bone marrow and blood. Could Pagel and his team more quickly identify high-risk AML patients, and more quickly get them a transplant? If they did, how much of a difference would it make to their survival? These are the questions the SWOG team set out to answer. To more rapidly identify high-risk patients, the SWOG team created a protocol that involved running a DNA test on patients immediately upon their AML diagnosis. The test checks for genetic mutations that signal high-risk - and likely extremely difficult to cure - variants of the disease, with results returning in about a week. Working with the National Marrow Donor Program (NMDP), they also created a process to rapidly identify stem cell donors for these high-risk patients. All patients in the trial got a cheek swab upon diagnosis, and DNA on the swab was used to find a donor in the worldwide registry, or investigators worked with relatives, such as siblings, to find a match even while the patient was undergoing chemotherapy. This coordinated, proactive approach is different. Often, doctors and patients wait until after chemotherapy, when the cancer returns, to begin to seek an allogeneic HCT. Pagel and his team enrolled 738 eligible patients to the trial, and 159 of them - or about 22 percent - were identified as high-risk. Out of 159 high-risk patients, 107 had the stem cell transplant. The results were clear. Pagel and his team increased the transplant rate for high-risk patients from the 40 percent standard to a whopping 64 percent. And two-year survival for high-risk patients also increased significantly. Typically, only about 22 percent of high-risk patients survive two years after their cancer diagnosis. Pagel and his team saw that two-year survival rate increase to 45 percent for high-risk patients who got the transplant. "The big message here is 'Don't delay identifying a donor,'" Pagel said. "Find these high-risk patients fast - and get them a transplant fast - and you can save lives. This only requires a simple, coordinated approach to testing and transplant searches. It's not complicated, but it makes an impact." The co-principal investigator of the S1203 study team is Dr. Guillermo Garcia-Manero of University of Texas MD Anderson Cancer Center. The study team also includes: Megan Othus, Ph.D., of Fred Hutchinson Cancer Research Center; Dr. Min Fang of the University of Washington and the Seattle Cancer Care Alliance; Dr. Jerald Radich of the University of Washington and the Seattle Cancer Care Alliance; Dr. David A. Rizzieri of Duke University and the Duke Cancer Institute; Dr. Guido Marcucci of City of Hope; Dr. Stephen A. Strickland, Jr. of Vanderbilt University and Vanderbilt-Ingram Cancer Center; Dr. Mark. R. Litzow of Mayo Clinic; Dr. M. Lynn Savoie of University of Calgary and Arnie Charbonneau Cancer Institute; Dr. Stephen R. Spellman of the Center for International Blood & Marrow Transplant Research; Dr. Dennis L. Confer of the National Marrow Donor Program; Dr. Jeffrey W. Chell of the National Marrow Donor Program; Dr. Maria Brown of Rush University Medical Center; Dr. Bruno Medeiros of Stanford University Medical Center; Dr. Mikkael Sekeres of Cleveland Clinic; Dr. Tara Lin of the University of Kansas Cancer Center; Dr. Geoffrey Uy of Washington University School of Medicine in St. Louis; Dr. Bayard L. Powell of Wake Forest Baptist Health; Dr. Jonathan Kolitz of Norwell Health; Dr. Richard A. Larson of the University of Chicago; Dr. Richard M. Stone of Dana-Farber Cancer Institute; Dr. David Claxton of Penn State Cancer Institute; Dr. James Essell of Oncology Health Care; Dr. Selina Luger from Penn Medicine; Dr. Sanjay Mohan from Vanderbilt University and Vanderbilt-Ingram Cancer Center; Anna Moseley, M.S. of Fred Hutchinson Cancer Research Center; Dr. Harry Erba of University of Alabama at Birmingham School of Medicine; and Frederick R. Appelbaum of Fred Hutchinson Cancer Research Center. S1203 was supported by the National Cancer Institute through grants CA180888; CA180819; CA18020; CA180821; CA180863; CA077202; and CCSRI 021039. SWOG is part of the National Cancer Institute's National Clinical Trials Network, the nation's oldest and largest cancer research network, and is a major part of the cancer research infrastructure in the U.S. and the world. SWOG has over 12,000 members in 46 states and six foreign countries who design and conduct cancer clinical trials to improve the lives of people with cancer. Founded in 1956, SWOG's 1,300 trials have led to the approval of 14 cancer drugs, changed more than 100 standards of cancer care, and saved more than 2 million years of human life. Learn more at swog.org.
News Article | November 8, 2016
(WASHINGTON, November 8, 2016) - The American Society of Hematology (ASH) has partnered with several organizations on independent educational programming designed to help address knowledge gaps in the diagnosis and treatment of acute myeloid leukemia (AML). The American Society for Clinical Pathology (ASCP), the Oncology Nursing Society (ONS), the National Marrow Donor Program®/Be The Match®, and The France Foundation have joined ASH to create and implement a specialized curriculum, titled "Acute Myeloid Leukemia MATTERS: A Multidisciplinary Approach To Testing and Diagnosis, Evaluation of Risk, and Personalized Treatment Selection." ASH received educational grant funding from Summit, N.J.-based Celgene Corporation to support this initiative. This year, approximately 20,000 Americans will be diagnosed with AML, a cancer of the blood and bone marrow. An estimated 10,000 people die from this disease each year. While there have been recent advances in the diagnosis and management of AML, specialists caring for these patients are not always aware of these advances and how to implement them for clinical benefit. The multidisciplinary cancer care team involved in the management of patients with AML may include hematology/oncology physicians, nurse practitioners, physician assistants, and nurses; hematopathologist/pathologists; and hematologists as well as other clinicians specializing in hematopoietic cell transplantation. AML MATTERS aims to address knowledge gaps in the entire multidisciplinary team, first by surveying AML care specialists to identify specific knowledge gaps and then by creating educational programs to address areas that are lacking. The program is intended to address issues pertaining to accurate diagnosis of AML, risk stratification of patients, appropriate treatment options based on clinical guidelines, monitoring and managing adverse events, and engaging and providing patients with information about the disease and their treatment options. "Caring for a patient with a challenging disease like AML requires the collaborative efforts of a highly skilled multidisciplinary team," said 2016 ASH President Charles S. Abrams, MD, of the University of Pennsylvania. "ASH is pleased to join a diverse and committed group of partners who represent all of the different types of providers who comprise the multidisciplinary team that cares for AML patients. By improving the way AML is approached from the bench to the bedside, we will change the survival prognosis for our patients." The curriculum, which will begin in 2017, includes four educational summits, presentations at both the ASH and ASCP annual meetings, and the creation of updated materials for physicians and nurses. "Celgene is committed to supporting this unique partnership of ASH, ASCP, ONS, National Marrow Donor Program®/Be The Match®, and the France Foundation in addressing educational gaps pertaining to the diagnosis and treatment of AML," said Mary Sugrue, MD, PhD, Executive Director of Celgene Corp. "Hematologic neoplasms have long been on the advancing edge of the personalized medicine revolution, and AML is no exception," said ASCP Past President Steven H. Kroft, MD, MASCP, of the Medical College of Wisconsin. "With the recent explosion of knowledge regarding molecular mechanisms of pathogenesis and refinement of pathologically defined risk factors, coupled with the availability of new treatment modalities, including target therapies, it becomes more important than ever for the caregiving team to understand the complexities of this disorder." "The Oncology Nursing Society is honored to join the American Society of Hematology in this new educational program to address the needs of patients with AML," said ONS Chief Clinical Officer Lisa Kennedy Sheldon, PhD, APRN, AOCNP®, FAAN, and editor of the Clinical Journal of Oncology Nursing. "Oncology nurses are integral members of the multidisciplinary oncology team and have a special focus on patient-centered care, assessing adverse events and educating patients about their disease. The new AML program will provide key concepts to healthcare providers and improve patient outcomes." "Hematopoietic cell transplantation (HCT) is a potentially curative therapy for many patients with AML," said Linda J. Burns, MD, vice president and medical director, health services research at the National Marrow Donor Program®/Be The Match®. "We look forward to collaborating with our partners in this unique educational effort to help the medical community better understand AML and therapies like HCT." "This is an exciting opportunity to facilitate an ongoing conversation between the collaborative care team and leverage recent advances in AML to affect patient care," said Ted Bruno, MD, chief medical officer of The France Foundation. "This educational effort will seek to create robust, real-world learning experiences that bolster clinician learning, patient engagement, and prepare the multidisciplinary care team for ongoing challenges and opportunities in AML patient care. The France Foundation is pleased to join this team of dedicated partners in an effort to improve the lives of individuals with AML." About the American Society of Hematology The American Society of Hematology (ASH) (http://www. ) is the world's largest professional society of hematologists dedicated to furthering the understanding, diagnosis, treatment, and prevention of disorders affecting the blood. For more than 50 years, the Society has led the development of hematology as a discipline by promoting research, patient care, education, training, and advocacy in hematology. The official journal of ASH is Blood (http://www. ), the most cited peer-reviewed publication in the field, which is available weekly in print and online.
News Article | February 17, 2017
The BMT Tandem Meetings of the American Society for Blood and Marrow Transplantation (ASBMT) and the Center for International Blood & Marrow Transplant Research (CIBMTR) will take place Feb. 22-26, 2017 at the Gaylord Palms Convention Center in Orlando, Fla. The combined scientific sessions offer investigators, clinicians, laboratory technicians, clinical research professionals, nurses, pharmacists, administrators, and allied health professionals the latest medical instruction in hematopoietic cell transplantation. Alongside the scientific education being offered will be posters and abstracts highlighting the best new research in the field, including: The ASBMT and CIBMTR will also honor a few of its members with awards and named lectures on Friday evening, Feb. 24, 2017 beginning at 5:00 PM. The ASBMT will induct Krishna Komanduri, MD of the University of Miami Miller School of Medicine as its new president. The CIBMTR welcomes its new Chair, Robert J. Soiffer, MD, of the Dana-Farber Cancer Institute. For complete details about the meeting, please visit http://bit.ly/2017Tandem. For a full list of best abstracts, visit http://bit.ly/BestAbs17 or for late breaking abstracts, visit http://bit.ly/BreakingAbs17. The American Society for Blood and Marrow Transplantation (ASBMT) is a professional society of more than 2,200 individuals from over 45 countries. The Society is dedicated to advancing the science and clinical care for patients who require blood and marrow transplants for blood cancers and other deadly diseases. The CIBMTR® (Center for International Blood and Marrow Transplant Research®) is a research collaboration between the National Marrow Donor Program® (NMDP)/Be The Match® and the Medical College of Wisconsin (MCW). The CIBMTR collaborates with the global scientific community to advance hematopoietic cell transplantation (HCT) and cellular therapy worldwide to increase survival and enrich quality of life for patients.
Confer D.L.,National Marrow Donor Program
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation | Year: 2010
HLA matching is the dominant controllable donor-recipient factor determining the outcome of adult unrelated donor hematopoietic cell transplantation. Beyond HLA, donor selection is often based on donor characteristics such as age, sex, parity, cytomegalovirus (CMV) serostatus, and ABO blood type. The published evidence to suggest these additional factors are important determinants of survival is weak and is sometimes conflicting. Other factors may be more important for optimal donor selection than the traditional non-HLA factors. These include the donor's geographic location, the performance history of the groups managing the donor, a priori knowledge of the donor's willingness/availability, and others. Implementation of tools to expose this additional donor-related information could significantly alter and aid unrelated donor selection practices. Copyright 2010 American Society for Blood and Marrow Transplantation. All rights reserved.
Hahn T.,National Marrow Donor Program
Journal of clinical oncology : official journal of the American Society of Clinical Oncology | Year: 2013
Over the past four decades, allogeneic hematopoietic cell transplantation (alloHCT) has evolved as a curative modality for patients with hematologic diseases. This study describes changes in use, technique, and survival in a population-based cohort. The study included 38,060 patients with hematologic malignancies or disorders who underwent first alloHCT in a US or Canadian center from 1994 to 2005 and were reported to the Center for International Blood and Marrow Transplant Research. AlloHCT as treatment for acute lymphoblastic (ALL) and myeloid leukemias (AML), myelodysplastic syndrome (MDS), and Hodgkin and non-Hodgkin lymphomas increased by 45%, from 2,520 to 3,668 patients annually. From 1994 to 2005, use of both peripheral (7% to 6%) and cord blood increased (2% to 10%), whereas use of marrow decreased (90% to 27%). Despite a median age increase from 33 to 40 years and % increase in unrelated donors for alloHCT, overall survival (OS) at day 100 significantly improved for patients with AML in first complete remission after myeloablative sibling alloHCT (85% to 94%; P < .001) and unrelated alloHCT (63% to 86%; P < .001); 1-year OS improved among those undergoing unrelated alloHCT (48% to 63%; P = .003) but not among those undergoing sibling alloHCT. Similar results were seen for ALL and MDS. Day-100 OS after cord blood alloHCT improved significantly from 60% to 78% (P < .001) for AML, ALL, MDS, and chronic myeloid leukemia. Use of reduced-intensity regimens increased, yielding OS rates similar to those of myeloablative regimens. Survival for those undergoing alloHCT has significantly improved over time. However, new approaches are needed to further improve 1-year OS.
LeMaistre C.F.,Sarah Cannon |
Farnia S.H.,National Marrow Donor Program
Biology of Blood and Marrow Transplantation | Year: 2015
Bundled payments for hematopoietic cell transplantation (HCT) have long been accepted by both commercial health insurance providers and transplant centers, effectively outpacing the use of this payment model elsewhere in health care. As with the rest of health care, interest in payment and health delivery reform has created demand for transplant providers to address value by incorporating quality metrics and strategic changes in network design The complexity of evaluating performance in HCT complicates the goal of rewarding providers for better performance and penalizing poor results. We provide an introduction to value-based purchasing and address potential considerations in the adoption of incentives to improve quality of care in HCT. © 2015 American Society for Blood and Marrow Transplantation.
Walker T.,National Marrow Donor Program
Clinical transplants | Year: 2011
Since its founding in 1986, the NMDP has grown into a large international organization, providing patients with access to more than 9.5 million adult donors on the Be The Match Registry and to more than 18.5 million adult donors worldwide. Patients searching through the NMDP also have access to nearly 165,000 CBUs from NMDP-affiliated cord blood banks and nearly 600,000 CBUs worldwide. Through aggressive recruitment to the Be The Match Registry, and by establishing connections to international registries, the NMDP gives patients in need of a transplant access to a large and diverse pool of unrelated donors and CBUs. This has resulted in a steady increase in the likelihood of finding a matching donor or CBU for searching patients of all races/ethnicities. The NMDP has also developed programs and initiatives that have successfully increased the efficiency of the search process, which has decreased the time to transplant. The NMDP has also developed strategies that have improved access to transplant, especially among minority racial/ethnic patient populations. These long-standing and ongoing efforts to grow the Be The Match Registry and to improve the search process resulted in a record number of NMDP-facilitated transplants in 2011--more than 5,500--and now have facilitated more than 50,000 transplants since 1986. However, the NMDP, using SEER data, has calculated that there are approximately 10,000 patients in the U.S. each year who could potentially benefit from unrelated donor HCT. The NMDP has therefore set a goal to facilitate 10,000 transplants annually. Although meeting this goal will require nearly doubling the annual rate of transplants, the NMDP is confident that it has the expertise, personnel, facilities, and commitment to achieve this goal.
National Marrow Donor Program | Date: 2017-01-13
computer software for accessing a database featuring information in the medical field, specifically, stem cell therapy related information.
Denzen E.M.,National Marrow Donor Program
Bone Marrow Transplantation | Year: 2016
Hematopoietic cell transplantation (HCT) is a procedure that can significantly influence the socioeconomic wellbeing of patients, caregivers and their families. Among 30 allogeneic HCT recipients and their caregivers enrolled on a pilot study evaluating the feasibility of studying financial impact of HCT, 16 agreed to participate in the long-term phase, completed a baseline questionnaire and received phone interviews at 6, 12, 18 and 24 months post HCT. Analyses showed that by 2 years post HCT, 54% of patients who previously contributed to household earnings had not returned to work and 80% of patients/caregivers reported transplant as having moderate to great impact on household income. However, patients’ levels of confidence in their abilities to meet household financial obligations increased from baseline to 2 years. A relatively large proportion of patients reported inability to pay for medical care through this time period. Case studies demonstrated that patients' individual perceptions of the financial impact of HCT varies considerably, regardless of actual income. We demonstrate the feasibility of conducting a study to evaluate the financial impact of allogeneic HCT through 2 years post transplantation. Some patients/caregivers continue to experience a significant long-term financial burden after this procedure. Our study lays the foundation for a larger evaluation of patient/caregiver financial burden associated with HCT.Bone Marrow Transplantation advance online publication, 18 April 2016; doi:10.1038/bmt.2016.103. © 2016 Macmillan Publishers Limited
News Article | December 23, 2016
The Texas Cord Blood Bank, a program of nonprofit biomedical organization GenCure and the designated public cord blood bank for the state of Texas, has received a grant to help minimize time between collection of donated umbilical cord blood and preserving those donations so they’re available for patients in need of a transplant. The grant is from the National Marrow Donor Program/Be The Match®. The Texas Cord Blood Bank (TCBB) and GenCure partner with Be The Match to add donors to a national registry for bone marrow, peripheral blood stem cells (PBSCs) and umbilical cord blood for patients who need transplants to help cure blood cancers and other diseases. Umbilical cord blood is rich in blood-forming stem cells, and though it’s normally discarded, moms can choose to donate their newborns’ umbilical cord blood after healthy births through TCBB. Cord blood stem cell transplantation can be an alternative treatment for patients when a bone marrow or PBSC match cannot be found. The $67,000 grant will help TCBB add an extra courier pickup of cord blood donations from Methodist Metropolitan Hospital in San Antonio as well as an extra laboratory shift to process the donations and get them into storage and onto the registry, ready for patients who are searching for them. “Reducing the time between collection and processing of generously donated umbilical cord blood may serve two purposes,” said Rogelio Zamilpa, director of the GenCure cord blood center. “It will help improve the quality of the donations, making them more effective for patients, and it will help us add more donations from minorities to the registry, which are desperately needed.” Because the biological markers used in matching are inherited, patients are more likely to match someone from their own race or ethnicity. Adding more donors from diverse racial and ethnic backgrounds to the registry increases the likelihood all patients will find the match they need. TCBB piloted a similar program at an Edinburg, Texas, hospital. In that pilot, donated cord blood units TCBB was able to collect for the registry increased by 58 percent; the majority were from minority donors. “The NMDP grant will allow us to improve our processes to ultimately serve patients better. Increasing donated cord blood collections, the quality of those collections and the number of minority collections will help ensure the availability of transplants for patients who are counting on them,” Zamilpa said. The Texas Cord Blood Bank has provided about 400 transplant matches around the world and currently banks 1,200 units that are available to patients. About GenCure: GenCure, a Texas nonprofit, focuses on regenerative medicine and uses the power of human cells and tissues to inspire hope, enhance lives and enable clinical advancements. Using processed tissue and cell-based therapies, GenCure works to connect health care requirements with innovative solutions that best serve the needs of the global patient community. The Texas Cord Blood Bank, established by the state legislature in 2003, is a program of GenCure. Visit us at http://www.gencure.org.