Dr. Bachier on the Evolution of Stem Cell Transplants in Hematologic Malignancies

Carlos R. Bachier, MD, director, blood and marrow transplant research, Sarah Cannon Research Institute, discusses the advancement of supportive care in hematologic malignancies.

Fifty years ago, bone marrow was the source of stem cells. Now, stem cells can be obtained from the peripheral blood. This has benefited patients in the autologous setting where their recovery of blood counts is much faster. The same is true in the allogeneic setting where donors are used.

One of the most important advances has been in supportive care, says Bachier. In transplants, particularly in the allogeneic transplant setting, patients can develop reactions such as graft-versus-host disease and infections. Over the past couple decades, therapies have been developed that have made transplants easier, lowered resulting toxicities, and improved overall survival.

Although advances have been made in supportive care, toxicity management still presents a challenge to physicians. Relapse remains the biggest challenge to physicians, especially in patients who have received an allogeneic transplant, Bachier explains. Ongoing studies are investigating methods of decreasing the rate of relapse after transplant.