Transplantation innovations developed at Fred Hutch include the “mini-transplant,” which requires a minimal dose of radiation and can be an alternative for patients who are unlikely to tolerate a traditional transplant. Our researchers have also played a key role in the development of the national marrow donor registry, conducted foundational research on donor-patient matching and made critical innovations in supportive care. For certain diseases, these advances have increased survival rates from zero to upwards of 90 percent. And our transplantation research offered the first definitive proof of immune cells’ power to cure cancer, kick-starting the now-burgeoning field of immunotherapy. Our research continues to advance the leading edge of transplantation and cellular therapy.
We are developing new ways to prevent and treat graft-vs.-host disease, in which transplanted donor immune cells attack the patient’s healthy tissues. For example, we are testing new pre-transplant drug regimens that might lower risk; filtering out certain risky cells before transplant; and developing targeted drugs that could shut down harmful immune reactions before they get out of hand.
A bone marrow or blood stem cell transplant is a potentially life-saving treatment, but it comes with potentially life-threatening risks. Transplant-associated mortality remains significant due to a variety of complications. Many researchers at Fred Hutch are aiming to improve transplant safety. They include Dr. Effie Wang Petersdorf, who studies how genetic factors influence the success of transplants and ways to improve matches between patients and unrelated donors. Dr. Filippo Milano and his colleagues have studied the use of umbilical cord blood for transplants in leukemia patients without a traditional donor match, finding better outcomes than with an unrelated donor in some settings. Numerous Fred Hutch researchers are developing lower-toxicity methods for preparing, or conditioning, patients for transplantation, such as a targeted form of radiation called radioimmunotherapy. And Fred Hutch had the world’s first program dedicated to addressing infectious complications of bone marrow transplant — which can include cytomegalovirus, influenza, pneumonia, herpes zoster and fungal infections — and our infectious-disease innovations continue to save lives.
The dozens of Fred Hutch researchers who are investigating ways to help transplant survivors include Dr. Eric Chow, who studies cardiovascular disease risk factors in transplant survivors, and Dr. Rachel B. Salit, who investigates ways to decrease relapse risk and improve long-term quality of life. In 2018, Fred Hutch researchers published the largest-ever study of the well-being of informal caregivers for blood stem cell of bone marrow transplant survivors.
Our Long-Term Follow-Up program provides lifelong monitoring and care of patients following a bone marrow or stem cell transplant. Researchers in this program work in partnership with patients’ doctors to resolve medical problems and gather information for research. This information is used to develop improved strategies for preventing and treating long-term effects of transplantation and to educate patients about post-transplant problems.