test

Stem Cell Transplant

The Yale Transplant Advantage

Yale-New Haven Hospital is a member of the National Marrow Donor Program and is accredited as a major transplant center by the FACT transplant accreditation committee.

In an effort to destroy abnormal cancerous cells in leukemia, lymphoma and multiple myeloma, stem cell transplants are often used. Yale is the only center in Connecticut offering allogeneic transplant, a transplant using compatible donor stem cells. The number of allogeneic transplants performed annually at Smilow Cancer Hospital has doubled in the last four years.

Bone marrow transplants and autologous transplants have been performed here since 1988. Led by Stuart Seropian, MD, the Allogeneic Bone Marrow and Stem Cell Transplantation program at the Yale Cancer Center was one of the first cancer centers to use the procedure to successfully treat cancer patients.

New clinical trials are available for patients who have not been successfully matched with a donor and are at high risk for relapse. Available in only a handful of cancer centers in the country, Yale Cancer Center is currently performing:

  • Haploidentical transplants, which allow patients to be transplanted with mismatched or half-matched donor stem cells from a family member with whom they have only one haplotype (set of genes) in common.
  • Non-myeloablative or reduced intensity transplants, which is a technique that uses a less intense treatment to prepare a patient for transplant and alternatively relies on the donor's immune cells combined with newer agents to fight the cancer. Of the 42 patients treated at Yale Cancer Center, 75% were over 55. Previously these patients would not have been eligible for transplant. Lead physician is Stuart Seropian, MD.

Stem cell allotransplantation can cause a side effect called Graft-Versus-Host disease in 40-50% of patients who receive transplant. Yale Cancer Center researchers have long been considered leaders in developing novel techniques to eliminate this disease. Advances include:

  • The discovery that dendritic, or immune cells, are necessary in causing graft-versus-host disease. The deletion of T-cells from the donor stem cells removes the incidence of graft-versus-host but may also decrease the effectiveness of the transplant. Lead physician is Warren Shlomchik, MD.

The introduction of intravenous infusions of autologous immature dendritic cells before an allogeneic transplant reduced the incidence rate from the average of 40-50 % to only 15 %. These findings, initially revealed through a study of 104 patients, are currently being confirmed through a national Phase II trial. Lead physician is Francine Foss, MD.

The National Marrow Donor Program tracks data on patients who have received a transplant at accredited United States Transplant Centers. Smilow Cancer Hospital/Yale Cancer Center’s actual results are above the predicted survival range. National one-year actual survival is 65% for the 18,947 patients transplanted in the United States last year. Learn More

The following chart shows how Yale Cancer Center compares to Transplant Centers in the United States Reporting More than 50 Allogeneic Transplants During the Last Reporting Period (2008 – 2010).

Institution

Number of Patients

Disease Severity*

One-Year Survival

Predicted Survival

Yale University/Yale-New Haven Hospital

125

3

70.00%

59.00%

B

209

3

72.00%

61.00%

C

135

2

72.00%

55.00%

D

635

3

67.00%

60.00%

E

366

3

73.00%

57.00%

F

441

1

67.00%

63.00%

G

382

2

70.00%

66.00%

H

769

4

73.00%

62.00%

I

250

2

65.00%

58.00%

J

92

1

66.00%

61.00%

K

237

2

54.00%

56.00%

L

271

2

71.00%

61.00%

M

90

3

65.00%

57.00%

N

753

3

68.00%

62.00%

O

251

2

67.00%

58.00%

P

401

3

54.00%

53.00%

Q

196

3

54.00%

58.00%

R

172

4

70.00%

51.00%

S

1003

4

62.00%

57.00%

T

127

3

66.00%

55.00%

U

200

2

63.00%

58.00%

V

351

5

51.00%

49.00%

W

183

4

54.00%

58.00%

X

414

3

65.00%

60.00%

Y

102

2

64.00%

61.00%

Z

395

2

73.00%

63.00%

AA

162

4

52.00%

48.00%

BB

220

3

62.00%

55.00%

CC

336

3

65.00%

59.00%

DD

213

5

55.00%

55.00%

EE

182

5

69.00%

57.00%

FF

184

4

62.00%

56.00%

GG

186

4

69.00%

58.00%

HH

171

4

52.00%

54.00%

II

338

4

59.00%

54.00%

JJ

132

4

61.00%

57.00%

KK

129

2

67.00%

59.00%

LL

77

5

64.00%

48.00%

MM

135

5

56.00%

54.00%

NN

287

4

62.00%

49.00%

OO

79

5

66.00%

52.00%

PP

121

4

54.00%

52.00%

QQ

74

5

54.00%

56.00%

RR

105

3

55.00%

59.00%

SS

160

5

75.00%

61.00%

TT

211

4

62.00%

60.00%

UU

89

5

58.00%

54.00%

VV

210

5

55.00%

58.00%

WW

89

4

54.00%

42.00%

XX

180

5

53.00%

57.00%

YY

96

4

54.00%

52.00%

* Disease Severity refers to the overall disease condition of patients and is a measure of patients' pre-transplant health characteristics that predict survival after transplantation. The risk categories, based on overall disease condition of treated patients, are measured on a scale from 1 (low risk) to 5 (high risk).