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Conference Celebrates10 Years of Stem Cell Transplantation

By John Iler

Honoring a decade of research in allogeneic bone marrow and stem cell transplantation, NHLBI held a 2-day celebration in September at the Clinical Center.

The first day of the conference was entitled "Allogeneic Stem Cell Transplantation: A Decade of Progress." Speakers included Dr. John Barrett, chief, stem cell allotransplantation section, Hematology Branch, NHLBI.

After citing an array of achievements since the transplant unit grafted its first patient on Sept. 20, 1993, the speakers detailed major developments at NIH supporting the success of the transplant procedure and outlining major improvements in the technique of allogeneic transplantation as a treatment for malignant blood diseases and solid tumors.

"This week, we will have transplanted just over 400 patients," Barrett noted. "We have striven to improve transplant outcome and have applied what we have learned from each transplant protocol to successive clinical studies."

Dr. David Biro
Some of the achievements, he said, include learning what the optimal stem cell dose is to obtain the best outcome and perfecting a technique of transplanting a donor's T-cell immune system, which minimizes graft-versus-host disease. "By reducing the immunosuppression given, we are able to enhance the unique graft-versus-malignancy effect of the donor immune system and extend the transplant approach…to successfully treat metastatic cancers such as renal cell cancer."

Barrett predicted that "in the next 10 years, we hope to create a transplant with close to zero mortality and anti-malignant effects which will allow us to use the procedure as a targeted approach to treat a widening spectrum of malignant and non-malignant diseases without restriction of age, performance status or matched donor availability."

The second day focused on transplant patients, their caregivers and donors. Clinical Center director Dr. John Gallin introduced keynote speaker Dr. David Biro, a Brooklyn dermatologist and author of the book One Hundred Days: My Unexpected Journey from Doctor to Patient.

"I had the misfortune, or maybe the good fortune, of being both a patient and a doctor," Biro said before the lecture. "A couple of months after my residency, I came down with a rare disease called PNH 3 paroxysmal nocturnal hemoglobinuria. It was a tendency to form blood clots and for the bone marrow to fail. A few months after my diagnosis, I ended up having a bone marrow transplant. Subsequently I wrote a book about my experience and that's why I'm here."

Attending the transplantation celebration were (from l) Dr. Neal Young, Dr. Elizabeth Nabel, Dr. John Barrett and former NHLBI director Dr. Claude Lenfant.

Also addressing issues of transplant recovery was Dr. Jean Henslee-Downey. Prior to her appointment as director of the Blood Resources Program, NHLBI, she had a distinguished career as a bone marrow transplant physician. "She has always had a particular interest in quality of life issues for marrow transplant survivors," said Barrett. "Her descriptions of a number of studies presenting factors which impact on the quality of life was therefore of special interest to our many transplant survivors and their families."

A plaque was presented to the transplant team by one grateful patient and to enthusiastic applause the first patient transplanted in 1993 was recognized, followed by similar recognition for the patients, their donors and caregivers.

Later in the day, a quilt by Lauren S. Kingsland, a Gaithersburg artist, was unveiled in honor of the NHLBI transplant recipients during the past 10 years. Discussions and services followed with patients and family members to address concerns following transplant and celebrate survivorship.

"We could not have achieved our results without the help and support from the Hematology Branch and the entire Clinical Center, which can rightly feel part of our program," concluded Barrett.

CC director Dr. John Gallin (second from r) is joined by (from l) Barrett, patient Carla Prudencio and her mother Ernestina de Prudencio.

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