Aaliyah Brown | December 26, 2024
Stem cell transplants, commonly known as hematopoietic stem cell transplants (HSCT), involve the replacement of damaged hematopoietic stem cells — multipotent cells capable of differentiating into all blood cell types — with healthy ones. These stem cells are crucial for maintaining the body’s ability to produce red blood cells, white blood cells, and platelets. In diseases such as multiple myeloma, Hodgkin lymphoma, and acute myeloid leukemia, the bone marrow’s ability to generate healthy blood cells is compromised either by the disease itself or by aggressive treatments like chemotherapy. Similarly, in genetic blood disorders like sickle cell anemia, stem cells carry mutations that affect blood cell function. By introducing healthy donor stem cells, this treatment can restore normal hematopoiesis, giving patients a renewed ability to combat infections, avoid anemia, and improve overall immune function, underscoring the importance of ongoing advancements in this field.
Vanderbilt-Ingram Cancer Center: “Center of Excellence”
Vanderbilt University Medical Center (VUMC) has emerged as a leader in stem cell transplants, with the Vanderbilt-Ingram Cancer Center (VICC) playing a pivotal role in pushing the boundaries of this treatment. The VICC Stem Cell Transplant Team has been performing these procedures since 2003 and has since grown into a world-renowned center. Its reputation has attracted patients from across the country, with Vanderbilt being designated as a “Center of Excellence” for stem cell transplants.
Over the years, Vanderbilt has made remarkable strides in improving both the safety and efficacy of stem cell transplants. These improvements combine cutting-edge research, personalized patient care, and innovative treatment protocols. By leveraging advances in immunotherapy, genetics, and precision medicine, the team at Vanderbilt has been able to tailor treatments to individual patient needs.
Innovations and research
One of the most notable innovations at Vanderbilt has been its ability to reduce transplant-related complications. For many patients undergoing stem cell transplants, the risk of graft versus host disease (GVHD), where the donor cells attack the recipient’s body, remains a significant challenge. Under the leadership of experts like Dr. Eric Tkaczyk, director of the Vanderbilt Dermatology Translational Research Clinic, the team has integrated cutting-edge research with clinical practice. For example, Dr. Eric Tkaczyk’s work focuses on leveraging machine learning to enhance the accuracy of GVHD diagnosis, particularly by automating the detection and classification of skin lesions. By developing deep learning models trained on thousands of patient images, the team aims to standardize assessments and reduce discrepancies among clinicians. This innovative approach not only improves diagnostic consistency but also supports the development of more effective treatments for GVHD.
In addition to preventing GVHD, VUMC has been a leader in the use of haploidentical stem cell transplants. This approach involves a donor who is only a half-match to the recipient, such as a parent or sibling, which expands the donor pool for patients with rare tissue types who would otherwise face challenges finding fully matched donors. Haploidentical transplants require advanced conditioning regimens and post-transplant immunosuppression to reduce the risk of GVHD and improve engraftment. At Vanderbilt, the use of T cell depletion techniques and post-transplant cyclophosphamide therapy has significantly reduced transplant-related mortality while maintaining high rates of disease remission. According to recent data from the center, the success rates of haploidentical transplants are comparable to those of fully matched transplants, making this method a viable and critical option for patients without a fully matched donor.
Cover photo courtesy of George Albu
References
Cleveland Clinic. (2022, March 14). Stem Cell Transplantation: What it Is, Process & Procedure. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/22567-stem-cell-transplants
Justiz Vaillant, A. A., & Mohammadi, O. (2020). Graft Versus Host Disease. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538235
Pasley, J. (2024, June 25). International trial introduces another curative option for sickle cell disease. VUMC News. https://news.vumc.org/2024/06/25/international-trial-introduces-another-curative-option-for-sickle-cell-disease/
Wilemon, T. (2018, November 2). Cancer Center among best in nation for stem cell transplant survival. VUMC News. https://news.vumc.org/2018/11/02/cancer-center-among-best-in-nation-for-stem-cell-transplant-survival/
Vanderbilt University Medical Center. (2020, April 7). New efforts to clarify GVHD. Discoveries in Medicine. https://discoveries.vanderbilthealth.com/2020/04/new-efforts-to-clarify-gvhd/
Loftus, T. J., Rosenthal, M. D., Croft, C. A., Dong, J., et al. (2023). Hyperinflammatory human responses to bacterial infections complicating critical illness. The New England Journal of Medicine, 388(10), 885-897. https://doi.org/10.1056/NEJMoa2215943
