What is going on with Bone Marrow Transplantation?
Lawrence A. Solberg, Jr., Ph.D., M.D., Director, Blood and Marrow Transplantation Program
Chair, Hematology-Oncology Division, Mayo Clinic
When I started doing bone marrow transplantation in 1982, we called it bone marrow transplantation! Now, most programs have different names reflecting major changes in technology. For example, many programs refer to themselves as "Blood and Marrow Transplantation Programs" or "Hematopoietic Stem Cell Transplantation Programs".
We now know that the cells that produce blood, variably referred to as hematopoietic stem cells or hematopoietic progenitor cells, are present not only in the marrow but also circulate in peripheral blood and in blood that can be collected from the placenta and umbilical veins. Certain treatments such as chemotherapy and the use of growth factors like granulocyte colony-stimulating-activity (G-CSF) can shift hematopoietic stem cells from the marrow compartment into the blood, a process called stem-cell mobilization. This makes collection of peripheral blood stem cells much more efficient. In many instances now, just one or two collections, each lasting about 3 hours, are required from patients or normal donors. The technology used to collect the peripheral blood stem cells is exactly the same outpatient procedure, called apheresis, as that used to collect platelets from normal donors!
The three basic types of donor sources still exist: allogeneic, syngeneic, or autologous. Allogeneic donors (from the same species unlike xenogeneic donors) can be obtained from related or unrelated donors. Syngeneic donors are identical twins. Autologous transplantation denotes the collection of blood forming stem cells from the marrow or blood of the patient.
So one can see why names are changing. Autologous transplants can now be from peripheral blood progenitor cells or from marrow. Allogeneic cells can now be from related or unrelated donors, and collected from blood, marrow, or umbilical cord blood.
Jacksonville has programs offering blood and marrow stem cell transplants to adult and pediatric patients. Our community also participates in the National Marrow Donor Program allowing citizens of Jacksonville and the surrounding area both to have access to donated bone marrow or umbilical cord blood from unrelated, anonymous donors and to voluntarily donate blood forming stem cells to others. In this issue, colleagues from Baptist Cancer Center, Nemours, and from University of Florida, Shands, have joined me to illustrate where blood and marrow transplantation stands in 2000 and to share with you an overview of the scope of these activities in Jacksonville.
Jacksonville Medicine / November, 2000
What's New
·
Northeast Florida Medicine Journal ·
Know Your Physician
· Legal
& Legislative
·
DCMS Alliance ·
Academy of Medicine ·
Member Websites ·
Community Health
About the DCMS ·
Meetings Calendar ·
Member Benefits
·
Employment Connection ·
Home
Duval County Medical Society
·
555 Bishopgate Lane
·
Jacksonville, FL 32204
Phone: (904) 355-6561
·
FAX: (904) 353-5848
General Email: dcms@dcmsonline.org
·
Webmaster's Email: mdoran@dcmsonline.org
Privacy Policy
and Disclaimers