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Bone Marrow and Blood Stem Cell Transplants

 
City of Hope’s Hematopoietic Cell Transplantation (HCT) program is one of the largest and most successful bone marrow and blood stem cell transplant centers in the world. As a pioneer in creating breakthrough treatments for all hematologic cancers and blood-related disorders, City of Hope’s Department of Hematology and Hematopoietic Cell Transplantation (HCT) is a world leader in setting standards for stem cell transplantation and in improving long-term outcomes for both children and adults.
 

Since City of Hope performed its first bone marrow transplant in 1976, more than 12,000 transplants have been completed for patients from virtually every state and around the world. City of Hope’s HCT program is dedicated to the traditional and newer uses of this procedure.
 
Specialists at City of Hope lead the field of stem cell transplantation with excellent outcomes.Transplant patients at City of Hope have ranged  from younger than one to 79 years old.

City of Hope is renowned for developing innovative transplant regimens that have improved the cure rate for patients with:
 
 
City of Hope’s Hematopoietic Cell Transplantation Program is accredited by the Foundation for the Accreditation of Cellular Therapy (FACT), the gold standard of excellence for blood and bone marrow transplant programs in the United States.
 
Additionally, the Center for International Blood and Marrow Transplant Research Center has ranked City of Hope as an “over-performing” transplant center with better than expected survival outcomes, and City of Hope is the only U.S. transplant center with this recognition for nine consecutive years.
 
 
As one of a select number of institutes to attain the elite designation of Comprehensive Cancer Center by the National Cancer Institute, City of Hope is acknowledged as a leader in cancer research and treatment.

If you have been diagnosed with a hematologic cancer or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 
 
 
 
 

Frequently Asked Questions

What are hematopoietic cell transplantation (HCT) and peripheral blood stem cell transplantation (PBSCT)?

HCT and PBSCT are procedures that use stem cells to treat a patient's malignancy or to repair diseased or defective bone marrow. A patient receives intensive chemotherapy with or without total body irradiation therapy in an attempt to kill all cancerous cells, but which also destroy his/her own bone marrow function. This therapy also causes immunosuppression, which prevents rejection of the newly transplanted stem cells from a related or unrelated donor.
 
There is little risk of rejection of a patient's own stem cells following autologous transplant. After transplantation, the new stem cells replace the damaged bone marrow and cells of the immune system.

How do HCT and PBSCT help patients?

HCT and PBSCT allow a patient to receive very high doses of chemotherapy and radiation designed to kill cancer cells. The high doses of therapy lead to the destruction of a patient's own marrow and immune system, which is then replaced by marrow from a donor or from peripheral blood stem cells that have been harvested before therapy.

How many HCTs and PBSCTs are performed at City of Hope?

City of Hope has performed more than 12,000 transplants for patients from virtually every state as well as from numerous countries. HCT and PBSCT patients at City of Hope have ranged in age from less than 1 year old to 79 years old. City of Hope's HCT program is one of America's largest, dedicated solely to the traditional and newer uses of this procedure.

Which diseases are HCT and PBSCT most frequently used to treat?

Allogeneic HCT is used primarily for the treatment of diseases that invade the bone marrow, such as  acute and chronic leukemia, myelodysplasia and  myeloma.
 
Autologous HCT is used primarily for the treatment of diseases such as lymphoma, Hodgkin disease, acute myelogenous leukemia, myeloma, breast cancer and testicular cancer.

What is the difference between autologous and allogeneic HCT?

Patients receive one of two types of stem cell-based transplants: autologous, in which a patient donates and receives back his/her own stem cells; or allogeneic, in which bone marrow-derived stem cells come from a related or unrelated donor whose human leukocyte antigens (HLA) are genetically matched with those of a patient.
 
Peripheral blood stem cells are generally used in autologous transplantations, while either marrow or peripheral blood stem cells are used in allogeneic transplantations.

How long have HCTs and PBSCTs been done?

This process was first used in the early 1970s. City of Hope's HCT Program began in 1976. City of Hope began performing PBSCTs in 1988.

How are donors for allogeneic transplantations found?

About 30 percent of patients needing a transplant get one from a family member whose HLA testing has identified compatibility between a patient and donor. This matching of donor and recipient reduces the chance of marrow rejection and greatly increases the likelihood of a successful transplant. The remaining 70 percent of patients must find an unrelated donor whose marrow is compatible.
 
Currently, there are nearly 5 million volunteer donors in the National Marrow Donor Program (NMDP) Be The Match Registry. Almost 50 percent of patients searching the registry have at least one identically matched, unrelated donor. The NMDP is conducting a major effort at the 97 donor centers around the United States (of which City of Hope is one) to increase minority registration.
 
As of January 2001, only 25 percent of the potential donors registered were from racial or ethnic minorities. Because HLA types vary greatly between people of different ethnic backgrounds, increasing minority and ethnic representation will increase minority patients' chances of finding matches.

What is a mini-HCT?

Mini-HCT is a procedure that allows successful transplant of bone marrow without the use of high-dose chemo and radiation therapy. It is less intensive but allows transplant to be utilized in the treatment of older patients who may not be able to endure the intensity of traditional HCT transplant regimens.
 
Because many diseases, such as leukemia, lymphoma, myeloma and myelodysplasia, are more common in older patients, mini-HCTs allow these patients to potentially benefit from transplant.
 

What is bone marrow?

Bone marrow is the soft, spongy material found inside bones. Bone marrow contains stem cells that give rise to white blood cells (to fight infections), red blood cells (for oxygenation) and platelets (to prevent hemorrhaging). The chief function of bone marrow is to produce blood cells.

What are platelets?

Platelets are critical in the clotting process and to help control bleeding. Platelets are commonly used to treat leukemia and cancer patients undergoing chemotherapy and bone marrow transplants. Platelets are also used for trauma patients.

What are stem cells?

All blood cells develop from very immature cells called stem cells. Most stem cells are found in the bone marrow, although some, called peripheral blood stem cells, circulate in blood vessels throughout the body. Stem cells can divide to form more stem cells, or they can go through a series of cell divisions by which they become fully mature blood cells.

Who can donate bone marrow or peripheral blood stem cells?

Donating bone marrow or stem cell to someone suffering from a life-threatening disease is one of the greatest gifts you can provide, the gift of life. The first step is to join the National Marrow Donor Program (NMDP) Be The Match Registry. The NMDP maintains the registry of potential donors and searches this when people need a match. To join the registry, you need to complete a brief health questionnaire, sign a consent form, and provide a small blood sample to determine your tissue type.
 
At City of Hope, we ask that you donate a unit of blood or platelets to help offset the cost of a tissue-type test. Your tissue type will be compared to the tissue types of thousands of patients awaiting a bone marrow transplant. If you are ever a potential match, the City of Hope Donor Center will notify you to see if you are still interested in continuing with the process. If you are, a City of Hope staff member will request an additional blood sample. This sample will determine if the donor matches well enough to continue with the process.

Will patients need blood and platelet donations?

Blood donations from friends and family are a great source of encouragement and support for a patient needing transfusions. If your blood type is compatible with the patient, your donated blood can be given directly to your loved one. If your blood is not the same type, it is still important that you donate to help other City of Hope patients who are a blood type match and seriously in need of your help.
 
In most circumstances, platelet donations do not need be the same blood type. Therefore, most friends and family members can direct their platelet donations to their loved one. Because platelets can only be stored for 3-5 days, consistent support for our patients is crucial. You can help rally friends and family members by sponsoring blood drives for patients as well as arranging for group donations in our Donor Center.
 
Encourage friends and family members to call the City of Hope Blood Donor Center at (626) 471-7171 and schedule an appointment to donate blood and/or platelets or make arrangements for a blood drive in your community. To find a blood drive in your community, please call 626-301-8385.

Why do patients need platelets?

Before a patient receives a donor's marrow, his or her own marrow must be destroyed by a rigorous treatment of chemotherapy and/or radiation. Once the patient receives the donated marrow, it takes about 4 to 8 weeks for the new marrow to produce platelets. During that time period, the patient needs transfusions of platelets to help his/her blood to clot. City of Hope patients sometimes receive platelet transfusion on a daily basis.

What are the risks to marrow donors?

Virtually none. Bone marrow is extracted under general anesthesia in a procedure that takes less than an hour. Donors have commented that their buttocks felt sore for several days after aspiration. Contrary to organ donations, marrow is completely replenished by the body within a couple of weeks. There are no increased risks to the donor during this period. Historically, at HCT centers around the world, marrow has been donated by individuals less than 1 year old to 60 or 70 years old.

What are the possible complications associated with HCT and PBSCT?

Immediately following allogeneic transplantation, patients are immunosuppressed and unable to fight infection. Different drugs are administered during this critical period and isolation is sometimes necessary for the patient.
 
Another possible complication for patients receiving allogeneic transplantation is known as graft-versus-host disease (GvHD). Despite the close match between patient and donor, in GvHD, the donated marrow may recognize its new home as foreign and react against the host.
 
In addition, patients can acquire post-transplant cytomegalovirus (CMV) pneumonia. City of Hope has pioneered several outstanding advances for the prevention and treatment of this potentially fatal complication. Recurrent disease also is possible if the pre-transplant chemotherapy and irradiation therapy were not successful in killing all malignant cells.
 
In autologous transplantations there are few complications once the patient leaves the hospital, and the only risk is whether the disease will return, causing relapse.

Hematologic Cancers/HCT Team

Research and Clinical Trials

City of Hope is recognized internationally for its breakthrough research discoveries and clinical trials for developing new ways to treat hematological cancers. Patients at City of Hope will have the ability to enroll in these trials, which can expand their treatment options and improve their outcomes. Learn more about our clinical trials program .
 
Highlights of our current research efforts include:

Reducing the Risk of GvHD
 
While stem cell transplants can be a lifesaving procedure for patients with hematologic disorders, it also carries a risk of graft versus host disease (GvHD), in which the newly transplanted stem cells do not recognize the recipient’s body as their own and start producing an immune response against it, leading to chronic and potentially serious complications. To reduce the likelihood of GvHD and to improve transplant outcomes, City of Hope is researching new ways to classify and match stem cell donors and recipients.
 
Adoptive T Cell Therapy
 
Harnessing the patient’s own immune system against the cancer, specifically through T-cell modification. In this experimental therapy, the patient’s own T-cells are extracted from the body, modified to recognize and attack cancer cells and re-infused back into the patient. This treatment has shown positive results for patients with lymphoma and lymphoid leukemia and is currently being studied for its potential against myeloid leukemia and multiple myelomaLearn more about our Adoptive T Cell Therapy research.
 
Nonmyeloablative (Mini) Transplants
 
Our use and refinement of nonmyeloablative (“mini”) transplants, which relies less on the heavy doses of chemotherapy and radiation and more on the anti-cancer effects of the transplant itself. This novel approach allows otherwise ineligible patients, such as older patients or those who cannot tolerate radiation/chemotherapy-related effects, to be treated with this lifesaving procedure. Learn more about nonmyeloablative transplants.
 
Specialized Drug Studies
 
Continual development and improvement of drug regimens to treat hematologic cancers. Recently, City of Hope had led a national study of the drug brentuximab in patients with relapsed Hodgkin lymphoma, in whom the drug produced a high rate of response compared to standard therapy.
 
Leukemia Stem Cell Research
 
The Division of Stem Cell and Leukemia Research s currently investigating leukemia stem cells, which several studies have suggested to cause leukemia. By identifying and eradicating these cancerous stem cells — instead of just the mature leukemia cells that conventional therapies target — a definitive cure for this disease can be achieved.
 
Long-term Follow-up Program
 
City of Hope has a formal Long-term Follow-up Program that monitors all patients who have received a transplant at City of Hope to ensure they have optimal quality of life following their diagnoses and treatments. The program also helps researchers compile data on long-term outcomes to increase awareness of the kinds of problems, both physical and psychological, that some patients face after transplant, so patients can receive timely and appropriate information and care.
 
National Cancer Institute Project Grant
 
The City of Hope’s hematology program has been continuously funded for nearly 30 years by the National Cancer Institute (NCI) to develop innovative therapies for people battling leukemia, lymphoma and other cancers. The NCI grant supports continuing research aimed at improving the outcome for patients undergoing either autologous or allogeneic transplant for a hematologic cancer. The grant also allows researchers at City of Hope to develop laboratory-based clinical studies to expand the scope and applications of stem cell transplants. These studies include incorporating gene transfer, molecular biology, radioimmunotherapy, cellular immunotherapy and genetics to improve transplant outcomes.
 
SPORE Grant
 
The City of Hope Hematologic Neoplasia Program was awarded a Specialized Program of Research Excellence (SPORE) grant to further its work in utilizing transplant and non-transplant approaches for the treatment of lymphoma. This SPORE is one of only three SPORE awards granted in the United States and builds upon the expertise in the transplant and cancer immunotherapy programs at City of Hope.
 
 
If you have been diagnosed with a hematologic cancer or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 

Karl G. Blume-Gerhard Schmidt Memorial Lecture in Transplantation Biology & Medicine

The annual City of Hope Celebration of Life Hematopoietic Cell Transplantation Reunion not only celebrates and commemorates survivors' lives, but also enables physicians and researchers to advance the science of hematopoietic cell transplantation, or HCT.
 
The Memorial Lecture, held each year in association with the annual HCT Reunion, commemorates the work and dedication of the late Gerhard Schmidt, M.D., who joined City of Hope's program in 1977 and established the Autologous Stem Cell Transplant and Histocompatibility Laboratory programs, among many other achievements. Schmidt lost his own battle with cancer in 1993.
 

2013 Lecture

In May 2013, hematology experts from around the country convened at City of Hope for the Blume-Schmidt Memorial Lecture in Transplantation Biology and Medicine to discuss the impact of Karl G. Blume, M.D., the founder of City of Hope's bone marrow transplant program. Blume launched the program in 1975, when such procedures were at the forefront of current science, and regarded as novelties in many circles. Today, that program is a world leader in hematopoietic cell transplantation.
 
 
 
 
As of this year, the lecture, viewable above, is known as the Karl G. Blume-Gerhard Schmidt Memorial Lecture in Transplantation Biology & Medicine.

The presenters and their topics:

Nelson J. Chao, M.D., M.B.A., chief of the Division of Cellular Therapy, Cell Therapy & Hematologic Malignancy Program at Duke University School of Medicine: “MicroRNAs as Biomarkers for GVHD.”

Robert S. Negrin, M.D., professor of medicine at Stanford University Medical Center: “GVHD from the Perspective of the T Cell.”

Frederick R. Appelbaum, M.D., member  and director of the Clinical Research Division at Fred Hutchinson Cancer Research Center and professor and head of the Division of Medical Oncology: “Simpler and More Accurate Prognostic Testing in Acute Leukemia.”

John A. Zaia, M.D., Aaron D. Miller and Edith Miller Chair in Gene Therapy, chair and professor of the Department of Virology, and professor of pediatrics at City of Hope: “Blood Stem Cell Transplantation for HIV/AIDS: Is this the Future?”

Stephen J. Forman, M.D., Francis & Kathleen McNamara Distinguished Chair in Hematology and Hematopoietic Cell Transplantation and chair of City of Hope’s Department of Hematology & Hematopoietic Cell Transplantation:  “T Cell Engineering to Improve the Graft Versus Leukemia Effect.”
 

Living with a Hematologic Cancer

City of Hope patients have access to the broad range of services offered by our  Department of Supportive Care Medicine. The department’s staff of professionals can give expert assistance in navigating a complex care as well as helping patients and loved ones with a variety of wellness issues including:
 
  • Managing side effects
  • Pain management
  • Coping and maintaining emotional/social/spiritual well-being
  • Staying healthy and active during/after treatment
  • Guidance on eating well and cooking smart
  • Healing arts
  • Being active
  • Building caregivers’ skills
  • Sexual health and fertility
  • Body image
 
 
The Sheri & Les Biller Patient and Family Resource Center is the heart of the Department of Supportive Care Medicine, integrating City of Hope's support services under one umbrella. The Biller Resource Center provides a warm and welcoming space where patients, families and caregivers can access the resources, education and support they need to strengthen and empower themselves, before, during and after treatment.

Our team of supportive care experts includes clinical social workers; pain and palliative care physicians and nurses; psychologists, psychiatrists; patient navigators; health educators; spiritual care chaplains; child life specialists and more. The Biller Resource Center staff may be reached at 626-256-4673 ext. 32273 (3CARE).
 
Other Resources
 
"A Patient's Guide to Blood and Marrow Stem Cell Transplantation at City of Hope" was developed to help City of Hope patients and their families learn about blood and marrow transplantation and what to expect before, during and after transplant at City of Hope.
 
 

If you have been diagnosed with a hematologic cancer or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.

Celebration of Life Bone Marrow Transplant/HCT Reunion

Bone marrow transplants offer a second chance for people with life-threatening blood cancers and other hematologic malignancies.  City of Hope performed its first bone marrow transplant in 1976. Since then, thousands of patients from virtually every state and dozens of countries have undergone bone marrow, cord blood or stem cell transplants at City of Hope.

City of Hope invites bone marrow transplant recipients and their families to attend the annual “Celebration of Life" event on the Duarte campus. The reunion has grown to more than 6,500 attendees from all over the United States and overseas. The reunion is a joyous day for everyone in attendance — physicians, nurses and former patients — as they celebrate the victories they have attained in fighting cancer. The day also features performances by former patients who entertain their fellow survivors and their families.

The patient-donor meeting is an emotional highlight of the event. Recipients, though overwhelmed with curiosity and the need to express their gratitude, can only dream of meeting the strangers who saved their lives. City of Hope makes that dream come true for two patients every year.

Watch videos, view pictures, read stories and learn more about the Celebration of Life Bone Marrow Transplant Reunion:
 
 
The annual reunion also enables physicians and researchers to advance the science of stem cell transplantation through the sharing of the findings and advances at the Karl G. Blume-Gerhard Schmidt Memorial Lecture held in conjunction with the reunion. The event commemorates the work and dedication of the late Gerhard Schmidt, M.D., who joined City of Hope's hematology program in 1977 and has made numerous contributions to the field throughout this career.
 
 
 
 
 

Support This Program

It takes the help of a lot of caring people to make hope a reality for our patients. City of Hope was founded by individuals' philanthropic efforts 100 years ago. Their efforts − and those of our supporters today − have built the foundation for the care we provide and the research we conduct. It enables us to strive for new breakthroughs and better therapies − helping more people enjoy longer, better lives.


For more information on supporting this specific program, please contact us below.

Tina Pakfar, DPPD
Vice President,
Philanthropy
Direct: 213-241-7216
Email: tpakfar@coh.org

 
 

Bone Marrow/Stem Cell Transplants

Bone Marrow and Blood Stem Cell Transplants

 
City of Hope’s Hematopoietic Cell Transplantation (HCT) program is one of the largest and most successful bone marrow and blood stem cell transplant centers in the world. As a pioneer in creating breakthrough treatments for all hematologic cancers and blood-related disorders, City of Hope’s Department of Hematology and Hematopoietic Cell Transplantation (HCT) is a world leader in setting standards for stem cell transplantation and in improving long-term outcomes for both children and adults.
 

Since City of Hope performed its first bone marrow transplant in 1976, more than 12,000 transplants have been completed for patients from virtually every state and around the world. City of Hope’s HCT program is dedicated to the traditional and newer uses of this procedure.
 
Specialists at City of Hope lead the field of stem cell transplantation with excellent outcomes.Transplant patients at City of Hope have ranged  from younger than one to 79 years old.

City of Hope is renowned for developing innovative transplant regimens that have improved the cure rate for patients with:
 
 
City of Hope’s Hematopoietic Cell Transplantation Program is accredited by the Foundation for the Accreditation of Cellular Therapy (FACT), the gold standard of excellence for blood and bone marrow transplant programs in the United States.
 
Additionally, the Center for International Blood and Marrow Transplant Research Center has ranked City of Hope as an “over-performing” transplant center with better than expected survival outcomes, and City of Hope is the only U.S. transplant center with this recognition for nine consecutive years.
 
 
As one of a select number of institutes to attain the elite designation of Comprehensive Cancer Center by the National Cancer Institute, City of Hope is acknowledged as a leader in cancer research and treatment.

If you have been diagnosed with a hematologic cancer or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 
 
 
 
 

FAQs

Frequently Asked Questions

What are hematopoietic cell transplantation (HCT) and peripheral blood stem cell transplantation (PBSCT)?

HCT and PBSCT are procedures that use stem cells to treat a patient's malignancy or to repair diseased or defective bone marrow. A patient receives intensive chemotherapy with or without total body irradiation therapy in an attempt to kill all cancerous cells, but which also destroy his/her own bone marrow function. This therapy also causes immunosuppression, which prevents rejection of the newly transplanted stem cells from a related or unrelated donor.
 
There is little risk of rejection of a patient's own stem cells following autologous transplant. After transplantation, the new stem cells replace the damaged bone marrow and cells of the immune system.

How do HCT and PBSCT help patients?

HCT and PBSCT allow a patient to receive very high doses of chemotherapy and radiation designed to kill cancer cells. The high doses of therapy lead to the destruction of a patient's own marrow and immune system, which is then replaced by marrow from a donor or from peripheral blood stem cells that have been harvested before therapy.

How many HCTs and PBSCTs are performed at City of Hope?

City of Hope has performed more than 12,000 transplants for patients from virtually every state as well as from numerous countries. HCT and PBSCT patients at City of Hope have ranged in age from less than 1 year old to 79 years old. City of Hope's HCT program is one of America's largest, dedicated solely to the traditional and newer uses of this procedure.

Which diseases are HCT and PBSCT most frequently used to treat?

Allogeneic HCT is used primarily for the treatment of diseases that invade the bone marrow, such as  acute and chronic leukemia, myelodysplasia and  myeloma.
 
Autologous HCT is used primarily for the treatment of diseases such as lymphoma, Hodgkin disease, acute myelogenous leukemia, myeloma, breast cancer and testicular cancer.

What is the difference between autologous and allogeneic HCT?

Patients receive one of two types of stem cell-based transplants: autologous, in which a patient donates and receives back his/her own stem cells; or allogeneic, in which bone marrow-derived stem cells come from a related or unrelated donor whose human leukocyte antigens (HLA) are genetically matched with those of a patient.
 
Peripheral blood stem cells are generally used in autologous transplantations, while either marrow or peripheral blood stem cells are used in allogeneic transplantations.

How long have HCTs and PBSCTs been done?

This process was first used in the early 1970s. City of Hope's HCT Program began in 1976. City of Hope began performing PBSCTs in 1988.

How are donors for allogeneic transplantations found?

About 30 percent of patients needing a transplant get one from a family member whose HLA testing has identified compatibility between a patient and donor. This matching of donor and recipient reduces the chance of marrow rejection and greatly increases the likelihood of a successful transplant. The remaining 70 percent of patients must find an unrelated donor whose marrow is compatible.
 
Currently, there are nearly 5 million volunteer donors in the National Marrow Donor Program (NMDP) Be The Match Registry. Almost 50 percent of patients searching the registry have at least one identically matched, unrelated donor. The NMDP is conducting a major effort at the 97 donor centers around the United States (of which City of Hope is one) to increase minority registration.
 
As of January 2001, only 25 percent of the potential donors registered were from racial or ethnic minorities. Because HLA types vary greatly between people of different ethnic backgrounds, increasing minority and ethnic representation will increase minority patients' chances of finding matches.

What is a mini-HCT?

Mini-HCT is a procedure that allows successful transplant of bone marrow without the use of high-dose chemo and radiation therapy. It is less intensive but allows transplant to be utilized in the treatment of older patients who may not be able to endure the intensity of traditional HCT transplant regimens.
 
Because many diseases, such as leukemia, lymphoma, myeloma and myelodysplasia, are more common in older patients, mini-HCTs allow these patients to potentially benefit from transplant.
 

What is bone marrow?

Bone marrow is the soft, spongy material found inside bones. Bone marrow contains stem cells that give rise to white blood cells (to fight infections), red blood cells (for oxygenation) and platelets (to prevent hemorrhaging). The chief function of bone marrow is to produce blood cells.

What are platelets?

Platelets are critical in the clotting process and to help control bleeding. Platelets are commonly used to treat leukemia and cancer patients undergoing chemotherapy and bone marrow transplants. Platelets are also used for trauma patients.

What are stem cells?

All blood cells develop from very immature cells called stem cells. Most stem cells are found in the bone marrow, although some, called peripheral blood stem cells, circulate in blood vessels throughout the body. Stem cells can divide to form more stem cells, or they can go through a series of cell divisions by which they become fully mature blood cells.

Who can donate bone marrow or peripheral blood stem cells?

Donating bone marrow or stem cell to someone suffering from a life-threatening disease is one of the greatest gifts you can provide, the gift of life. The first step is to join the National Marrow Donor Program (NMDP) Be The Match Registry. The NMDP maintains the registry of potential donors and searches this when people need a match. To join the registry, you need to complete a brief health questionnaire, sign a consent form, and provide a small blood sample to determine your tissue type.
 
At City of Hope, we ask that you donate a unit of blood or platelets to help offset the cost of a tissue-type test. Your tissue type will be compared to the tissue types of thousands of patients awaiting a bone marrow transplant. If you are ever a potential match, the City of Hope Donor Center will notify you to see if you are still interested in continuing with the process. If you are, a City of Hope staff member will request an additional blood sample. This sample will determine if the donor matches well enough to continue with the process.

Will patients need blood and platelet donations?

Blood donations from friends and family are a great source of encouragement and support for a patient needing transfusions. If your blood type is compatible with the patient, your donated blood can be given directly to your loved one. If your blood is not the same type, it is still important that you donate to help other City of Hope patients who are a blood type match and seriously in need of your help.
 
In most circumstances, platelet donations do not need be the same blood type. Therefore, most friends and family members can direct their platelet donations to their loved one. Because platelets can only be stored for 3-5 days, consistent support for our patients is crucial. You can help rally friends and family members by sponsoring blood drives for patients as well as arranging for group donations in our Donor Center.
 
Encourage friends and family members to call the City of Hope Blood Donor Center at (626) 471-7171 and schedule an appointment to donate blood and/or platelets or make arrangements for a blood drive in your community. To find a blood drive in your community, please call 626-301-8385.

Why do patients need platelets?

Before a patient receives a donor's marrow, his or her own marrow must be destroyed by a rigorous treatment of chemotherapy and/or radiation. Once the patient receives the donated marrow, it takes about 4 to 8 weeks for the new marrow to produce platelets. During that time period, the patient needs transfusions of platelets to help his/her blood to clot. City of Hope patients sometimes receive platelet transfusion on a daily basis.

What are the risks to marrow donors?

Virtually none. Bone marrow is extracted under general anesthesia in a procedure that takes less than an hour. Donors have commented that their buttocks felt sore for several days after aspiration. Contrary to organ donations, marrow is completely replenished by the body within a couple of weeks. There are no increased risks to the donor during this period. Historically, at HCT centers around the world, marrow has been donated by individuals less than 1 year old to 60 or 70 years old.

What are the possible complications associated with HCT and PBSCT?

Immediately following allogeneic transplantation, patients are immunosuppressed and unable to fight infection. Different drugs are administered during this critical period and isolation is sometimes necessary for the patient.
 
Another possible complication for patients receiving allogeneic transplantation is known as graft-versus-host disease (GvHD). Despite the close match between patient and donor, in GvHD, the donated marrow may recognize its new home as foreign and react against the host.
 
In addition, patients can acquire post-transplant cytomegalovirus (CMV) pneumonia. City of Hope has pioneered several outstanding advances for the prevention and treatment of this potentially fatal complication. Recurrent disease also is possible if the pre-transplant chemotherapy and irradiation therapy were not successful in killing all malignant cells.
 
In autologous transplantations there are few complications once the patient leaves the hospital, and the only risk is whether the disease will return, causing relapse.

HCT Team

Hematologic Cancers/HCT Team

Research and Clinical Trials

Research and Clinical Trials

City of Hope is recognized internationally for its breakthrough research discoveries and clinical trials for developing new ways to treat hematological cancers. Patients at City of Hope will have the ability to enroll in these trials, which can expand their treatment options and improve their outcomes. Learn more about our clinical trials program .
 
Highlights of our current research efforts include:

Reducing the Risk of GvHD
 
While stem cell transplants can be a lifesaving procedure for patients with hematologic disorders, it also carries a risk of graft versus host disease (GvHD), in which the newly transplanted stem cells do not recognize the recipient’s body as their own and start producing an immune response against it, leading to chronic and potentially serious complications. To reduce the likelihood of GvHD and to improve transplant outcomes, City of Hope is researching new ways to classify and match stem cell donors and recipients.
 
Adoptive T Cell Therapy
 
Harnessing the patient’s own immune system against the cancer, specifically through T-cell modification. In this experimental therapy, the patient’s own T-cells are extracted from the body, modified to recognize and attack cancer cells and re-infused back into the patient. This treatment has shown positive results for patients with lymphoma and lymphoid leukemia and is currently being studied for its potential against myeloid leukemia and multiple myelomaLearn more about our Adoptive T Cell Therapy research.
 
Nonmyeloablative (Mini) Transplants
 
Our use and refinement of nonmyeloablative (“mini”) transplants, which relies less on the heavy doses of chemotherapy and radiation and more on the anti-cancer effects of the transplant itself. This novel approach allows otherwise ineligible patients, such as older patients or those who cannot tolerate radiation/chemotherapy-related effects, to be treated with this lifesaving procedure. Learn more about nonmyeloablative transplants.
 
Specialized Drug Studies
 
Continual development and improvement of drug regimens to treat hematologic cancers. Recently, City of Hope had led a national study of the drug brentuximab in patients with relapsed Hodgkin lymphoma, in whom the drug produced a high rate of response compared to standard therapy.
 
Leukemia Stem Cell Research
 
The Division of Stem Cell and Leukemia Research s currently investigating leukemia stem cells, which several studies have suggested to cause leukemia. By identifying and eradicating these cancerous stem cells — instead of just the mature leukemia cells that conventional therapies target — a definitive cure for this disease can be achieved.
 
Long-term Follow-up Program
 
City of Hope has a formal Long-term Follow-up Program that monitors all patients who have received a transplant at City of Hope to ensure they have optimal quality of life following their diagnoses and treatments. The program also helps researchers compile data on long-term outcomes to increase awareness of the kinds of problems, both physical and psychological, that some patients face after transplant, so patients can receive timely and appropriate information and care.
 
National Cancer Institute Project Grant
 
The City of Hope’s hematology program has been continuously funded for nearly 30 years by the National Cancer Institute (NCI) to develop innovative therapies for people battling leukemia, lymphoma and other cancers. The NCI grant supports continuing research aimed at improving the outcome for patients undergoing either autologous or allogeneic transplant for a hematologic cancer. The grant also allows researchers at City of Hope to develop laboratory-based clinical studies to expand the scope and applications of stem cell transplants. These studies include incorporating gene transfer, molecular biology, radioimmunotherapy, cellular immunotherapy and genetics to improve transplant outcomes.
 
SPORE Grant
 
The City of Hope Hematologic Neoplasia Program was awarded a Specialized Program of Research Excellence (SPORE) grant to further its work in utilizing transplant and non-transplant approaches for the treatment of lymphoma. This SPORE is one of only three SPORE awards granted in the United States and builds upon the expertise in the transplant and cancer immunotherapy programs at City of Hope.
 
 
If you have been diagnosed with a hematologic cancer or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.
 

Blume-Schmidt Lecture

Karl G. Blume-Gerhard Schmidt Memorial Lecture in Transplantation Biology & Medicine

The annual City of Hope Celebration of Life Hematopoietic Cell Transplantation Reunion not only celebrates and commemorates survivors' lives, but also enables physicians and researchers to advance the science of hematopoietic cell transplantation, or HCT.
 
The Memorial Lecture, held each year in association with the annual HCT Reunion, commemorates the work and dedication of the late Gerhard Schmidt, M.D., who joined City of Hope's program in 1977 and established the Autologous Stem Cell Transplant and Histocompatibility Laboratory programs, among many other achievements. Schmidt lost his own battle with cancer in 1993.
 

2013 Lecture

In May 2013, hematology experts from around the country convened at City of Hope for the Blume-Schmidt Memorial Lecture in Transplantation Biology and Medicine to discuss the impact of Karl G. Blume, M.D., the founder of City of Hope's bone marrow transplant program. Blume launched the program in 1975, when such procedures were at the forefront of current science, and regarded as novelties in many circles. Today, that program is a world leader in hematopoietic cell transplantation.
 
 
 
 
As of this year, the lecture, viewable above, is known as the Karl G. Blume-Gerhard Schmidt Memorial Lecture in Transplantation Biology & Medicine.

The presenters and their topics:

Nelson J. Chao, M.D., M.B.A., chief of the Division of Cellular Therapy, Cell Therapy & Hematologic Malignancy Program at Duke University School of Medicine: “MicroRNAs as Biomarkers for GVHD.”

Robert S. Negrin, M.D., professor of medicine at Stanford University Medical Center: “GVHD from the Perspective of the T Cell.”

Frederick R. Appelbaum, M.D., member  and director of the Clinical Research Division at Fred Hutchinson Cancer Research Center and professor and head of the Division of Medical Oncology: “Simpler and More Accurate Prognostic Testing in Acute Leukemia.”

John A. Zaia, M.D., Aaron D. Miller and Edith Miller Chair in Gene Therapy, chair and professor of the Department of Virology, and professor of pediatrics at City of Hope: “Blood Stem Cell Transplantation for HIV/AIDS: Is this the Future?”

Stephen J. Forman, M.D., Francis & Kathleen McNamara Distinguished Chair in Hematology and Hematopoietic Cell Transplantation and chair of City of Hope’s Department of Hematology & Hematopoietic Cell Transplantation:  “T Cell Engineering to Improve the Graft Versus Leukemia Effect.”
 

Living with Cancer

Living with a Hematologic Cancer

City of Hope patients have access to the broad range of services offered by our  Department of Supportive Care Medicine. The department’s staff of professionals can give expert assistance in navigating a complex care as well as helping patients and loved ones with a variety of wellness issues including:
 
  • Managing side effects
  • Pain management
  • Coping and maintaining emotional/social/spiritual well-being
  • Staying healthy and active during/after treatment
  • Guidance on eating well and cooking smart
  • Healing arts
  • Being active
  • Building caregivers’ skills
  • Sexual health and fertility
  • Body image
 
 
The Sheri & Les Biller Patient and Family Resource Center is the heart of the Department of Supportive Care Medicine, integrating City of Hope's support services under one umbrella. The Biller Resource Center provides a warm and welcoming space where patients, families and caregivers can access the resources, education and support they need to strengthen and empower themselves, before, during and after treatment.

Our team of supportive care experts includes clinical social workers; pain and palliative care physicians and nurses; psychologists, psychiatrists; patient navigators; health educators; spiritual care chaplains; child life specialists and more. The Biller Resource Center staff may be reached at 626-256-4673 ext. 32273 (3CARE).
 
Other Resources
 
"A Patient's Guide to Blood and Marrow Stem Cell Transplantation at City of Hope" was developed to help City of Hope patients and their families learn about blood and marrow transplantation and what to expect before, during and after transplant at City of Hope.
 
 

If you have been diagnosed with a hematologic cancer or are looking for a second opinion consultation about your treatment, find out more about becoming a patient or contact us at 800-826-HOPE.

BMT/HCT Reunions

Celebration of Life Bone Marrow Transplant/HCT Reunion

Bone marrow transplants offer a second chance for people with life-threatening blood cancers and other hematologic malignancies.  City of Hope performed its first bone marrow transplant in 1976. Since then, thousands of patients from virtually every state and dozens of countries have undergone bone marrow, cord blood or stem cell transplants at City of Hope.

City of Hope invites bone marrow transplant recipients and their families to attend the annual “Celebration of Life" event on the Duarte campus. The reunion has grown to more than 6,500 attendees from all over the United States and overseas. The reunion is a joyous day for everyone in attendance — physicians, nurses and former patients — as they celebrate the victories they have attained in fighting cancer. The day also features performances by former patients who entertain their fellow survivors and their families.

The patient-donor meeting is an emotional highlight of the event. Recipients, though overwhelmed with curiosity and the need to express their gratitude, can only dream of meeting the strangers who saved their lives. City of Hope makes that dream come true for two patients every year.

Watch videos, view pictures, read stories and learn more about the Celebration of Life Bone Marrow Transplant Reunion:
 
 
The annual reunion also enables physicians and researchers to advance the science of stem cell transplantation through the sharing of the findings and advances at the Karl G. Blume-Gerhard Schmidt Memorial Lecture held in conjunction with the reunion. The event commemorates the work and dedication of the late Gerhard Schmidt, M.D., who joined City of Hope's hematology program in 1977 and has made numerous contributions to the field throughout this career.
 
 
 
 
 

Support This Program

Support This Program

It takes the help of a lot of caring people to make hope a reality for our patients. City of Hope was founded by individuals' philanthropic efforts 100 years ago. Their efforts − and those of our supporters today − have built the foundation for the care we provide and the research we conduct. It enables us to strive for new breakthroughs and better therapies − helping more people enjoy longer, better lives.


For more information on supporting this specific program, please contact us below.

Tina Pakfar, DPPD
Vice President,
Philanthropy
Direct: 213-241-7216
Email: tpakfar@coh.org

 
 
Quick Links
About the HCT Program
Stephen J. Forman, M.D., chair of hematology and hematopoietic cell transplantation, shares his views on the essence of care at City of Hope. He highlights the bone marrow transplant program (BMT) and the program's growth over the years.
 
Other videos:
 
Past BMT Reunions
Each year, City of Hope invites bone marrow transplant recipients and their families to attend the "Celebration of Life" event. View highlights from past reunions.
 
The focus of the Division of Hematopoietic Stem Cell and Leukemia Research is to improve the understanding of leukemia stem cells in order to develop cures for leukemia and other hematologic malignancies.
City of Hope's partnership with the Los Angeles Dodgers, includes ThinkCure!, an innovative, community-based non-profit that raises funds to accelerate collaborative research at City of Hope and Childrens Hospital Los Angeles to cure cancers.
 
NEWS & UPDATES
  • Rob Darakjian was diagnosed with acute lymphoblastic leukemia at just 19 years old. He began chemotherapy and was in and out of the hospital for four months. After his fourth round of treatment, he received a bone marrow transplantation from an anonymous donor. Today, he’s cancer free. In his first post, ...
  • Advanced age tops the list among breast cancer risk factor for women. Not far behind is family history and genetics. Two City of Hope researchers delving deep into these issues recently received important grants to advance their studies. Arti Hurria, M.D., director of the Cancer and Aging Research Program, and ...
  • City of Hope is extending the reach of its lifesaving mission well beyond U.S. borders. To that end, three distinguished City of Hope leaders visited China earlier this year to lay the foundation for the institution’s new International Medicine Program. The program is part of City of Hope’s strategi...
  • A hallmark of cancer is that it doesn’t always limit itself to a primary location. It spreads. Breast cancer and lung cancer in particular are prone to spread, or metastasize, to the brain. Often the brain metastasis isn’t discovered until years after the initial diagnosis, just when patients were beginning to ...
  • Blueberries, cinnamon, baikal scullcap, grape seed extract (and grape skin extract), mushrooms, barberry, pomegranates … all contain compounds with the potential to treat, or prevent, cancer. Scientists at City of Hope have found tantalizing evidence of this potential and are determined to explore it to t...
  • Most women who are treated for breast cancer with a mastectomy do not choose to undergo reconstructive surgery. The reasons for this, according to a recent JAMA Surgery study, vary. Nearly half say they do not want any additional surgery, while nearly 34 percent say breast cancer reconstruction simply isn’t imp...
  • The leading risk factor for breast cancer is simply being a woman. The second top risk factor is getting older. Obviously, these two factors cannot be controlled, which is why all women should be aware of their risk and how to minimize those risks. Many risk factors can be mitigated, and simple changes can lead...
  • All women are at some risk of developing the disease in their lifetimes, but breast cancer, like other cancers, has a disproportionate effect on minorities. Although white women have the highest incidence of breast cancer, African-American women have the highest breast cancer death rates of all racial and ethni...
  • First, the good news: HIV infections have dropped dramatically over the past 30 years. Doctors, researchers and health officials have made great strides in preventing and treating the disease, turning what was once a death sentence into, for some, a chronic condition. Now, the reality check: HIV is still a worl...
  • Screening for breast cancer has dramatically increased the number of cancers found before they cause symptoms – catching the disease when it is most treatable and curable. Mammograms, however, are not infallible. It’s important to conduct self-exams, and know the signs and symptoms that should be checked by a h...
  • Rob Darakjian was diagnosed with acute lymphoblastic leukemia at just 19 years old. He began chemotherapy and was in and out of the hospital for four months. After his fourth round of treatment, he received a bone marrow transplantation from an anonymous donor. Today, he’s cancer free.   In his previ...
  • In a single day, former professional triathlete Lisa Birk learned she couldn’t have children and that she had breast cancer. “Where do you go from there?” she asks. For Birk, who swims three miles, runs 10 miles and cycles every day, the answer  ultimately was a decision to take control of her cancer care. Afte...
  • More and more people are surviving cancer, thanks to advanced cancer treatments and screening tools. Today there are nearly 14.5 million cancer survivors in the United States. But in up to 20 percent of cancer patients, the disease ultimately spreads to their brain. Each year, nearly 170,000 new cases of brain ...
  • Cancer cells are masters of survival. Despite excessive damage to their most basic workings and the constant vigilance of the body’s immune system, they manage to persevere. Much of this extraordinary ability to survive falls under the control of proteins bearing the name STAT, short for signal transducer and a...
  • One person receives the breast cancer diagnosis, but the cancer affects the entire family. Couples, in particular, can find the diagnosis and treatment challenging, especially if they have traditional male/female communication styles. “Though every individual is unique, men and women often respond differently d...