AUSTIN, Texas—St. David’s South Austin Medical Center recently performed the first allogeneic stem cell transplant—a type of hematopoietic stem cell or bone marrow transplant (BMT)—in Austin. Allogeneic BMTs are procedures during which stem cells from a human leukocyte antigen (HLA) compatible donor are harvested, stored and transplanted into the patient after the patient receives high doses of chemotherapy and/or radiation. Allogeneic BMT procedures are designed to treat a variety of blood cancers and diseases by suppressing the disease and restoring the patient’s immune system.
“We are pleased to provide this advanced level of cancer care for patients,” Aravind Ramakrishnan, M.D., BMT physician with the Texas Transplant Institute at the Sarah Cannon Blood Cancer Center at St. David’s South Austin Medical Center, said. “Previously, patients would relocate to Houston, San Antonio or Dallas for three to five months, depending on the health of the patient; this can be cost prohibitive and disruptive. With this service, we hope to make a difficult time a little easier for patients, allowing them to heal with the support of family and friends nearby.”
During an allogeneic stem cell transplant, stem cells can be acquired from a related or unrelated donor who is HLA-matched. When receiving stem cells from a family member, siblings usually provide the best match, although a patient’s parent or child (over the age of 18) may also be tested to determine if he or she is an adequate match. Unrelated donors are identified via the National Marrow Donor Program.
Stem cell donation is performed on an outpatient basis. Donors undergo a series of injections to stimulate the stem cells to enter the blood stream, and once they reach a certain level, the cells are withdrawn from the donor during a painless procedure.
To prepare for the allogeneic transplant, stem cell transplant recipients undergo very high doses of chemotherapy and/or radiation (a process called total body irradiation, or TBI) for several days to destroy the underlying disease and suppress the immune system so that it will accept the donor cells.
“Total body irradiation is part of the conditioning regimen which is a critical part of the allogeneic BMT process,” Ryan Tierney, M.D., a radiation oncologist at Texas Oncology who practices at St. David’s South Austin Medical Center, said. “Texas Oncology added this service at its South Austin location to support the comprehensive allogeneic BMT program at St. David’s South Austin Medical Center.”
After undergoing TBI and chemotherapy, the donated stem cells are then infused into the patient’s blood stream, similar to a blood transfusion. Because the patient’s blood count drops during this treatment, he or she is at an increased risk of infection and bleeding. After the transplant is complete, a variety of complications can occur; as such, the patient must stay near the hospital for three to five months.
“Providing patients the comprehensive care for allogeneic stem cell transplants, now including TBI, is a major advancement in blood cancer treatment in Austin,” Laurence Tokaz, M.D., medical oncologist at Texas Oncology and medical director of the Sarah Cannon Blood Cancer Center at St. David’s South Austin Medical Center, said. “Minimizing stress and disruption for patients receiving this complex treatment is a significant benefit for them and their supporting family and friends.”
In 2014, St. David’s South Austin Medical Center performed the first adult autologous hematopoietic stem cell transplant, a type of BMT in which the patient’s own stem cells are used during the transplant, allowing patients suffering from blood cancers to receive treatment in Austin. Before this, patients had to go to Houston, Dallas or San Antonio for this level of care, where they would to stay for weeks or even months. In 2015, St. David’s South Austin Medical Center began performing state-of-the-art outpatient care for patients who have blood cancers—allowing them to receive a bone marrow transplant as an outpatient. These patients, who are otherwise healthy, can now stay at home throughout their treatment, with daily visits to the hospital.
“This is an important milestone for the development of bone marrow transplant care at St. David’s South Austin Medical Center,” Dr. Ramakrishnan said. “We now offer the complete continuum of care for blood-related malignancies right here in Austin.”
St. David’s South Austin Medical Center
St. David’s South Austin Medical Center is part of St. David’s HealthCare, one of the largest health systems in Texas, which was recognized with a Malcolm Baldrige National Quality Award in 2014. St. David's South Austin Medical Center is an acute care facility with 316 beds, offering a range of complex specialties and sub-specialties, including a nationally accredited oncology program with the area’s only adult bone marrow transplant program; a trauma program that includes all of the capabilities and programmatic elements of a Level II trauma center to treat the most severely injured and critical patients; a comprehensive cardiac program; full-service maternity and newborn care with Level I and II nurseries; and two full-service emergency centers in the communities of Bee Cave and Bastrop.
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