While reviewing patients' charts early in the morning, pediatric hematologist-oncologist Christopher Dvorak , MD, used to feel his heart race when he read about a child with blood cancer getting a stem cell transplant.
Stem cells are the body's building block cells that can develop into other cells, such as blood cells. A stem cell transplant - a procedure that replaces unhealthy stem cells with healthy ones - helps increase children's chances of surviving blood cancers, like leukemia, and other blood-based illnesses.
Before a transplant, patients receive chemotherapy and radiation to 'condition' their body to accept the new, healthy stem cells. The conditioning eliminates the body's current stem cells, weakens the immune system, and destroys any remaining cancerous cells. Even so, Chris knew the long-term prognoses for these kids were grim. Historically, only a third of blood cancer patients who received a stem cell transplant survived three years without relapse.
These days, however, Dvorak and fellow transplant specialists at UCSF Benioff Children's Hospital's Blood & Marrow Transplant Clinic are breathing easier. Recent research showed that over 86% of children survived three years without relapse thanks to a new conditioning treatment Dvorak's team developed.
The findings, reported in Blood Advances and supported by the National Institutes of Health (NIH) through the National Cancer Institute (NCI), mean more children are surviving with little reminder of ever having had childhood cancer.
The original chemotherapy conditioning guidelines - still used today in children - were developed over 50 years ago for adults and based merely on height and weight. To achieve higher survival rates and reduce long-term side effects, Dvorak and his team developed a conditioning treatment that gives children the least amount of chemotherapy needed and skips radiation entirely.
"Optimal chemotherapy conditioning accounts for not only children's height and weight but also many other personalized factors like immune cell count and kidney function that helps us calculate a precise amount of chemotherapy and eliminate the need for radiation," said Dvorak, lead study author and chief of the UCSF Allergy, Immunology and Bone Marrow Transplantation Division in Pediatrics.
