Tailored Clinical Care for Bone Marrow Transplant
Bone marrow transplant patients at NewYorkPresbyterian/Columbia now have a unit of their own. The Irving Bone Marrow Transplant Unit is a state-of-the-art facility for comprehensive bone marrow transplant care.
The unit features 18 inpatient rooms, a hightech nurses’ station for individual patient monitoring, and a specialized airflow system to help protect patients with weakened immune systems. The unit is supported by a $20 million gift from Herbert and Florence Irving.
The Irving Bone Marrow Transplant Unit is designed to deliver patient-centered care for bone marrow transplant recipients and to advance research to make BMT a safe and viable lifesaving therapy for a wide range of patients. Bone marrow, the body’s factory for making all types of blood cells, can be affected by benign blood disorders, such as severe aplastic anemia and sickle cell anemia, and malignant blood disorders, such as acute leukemias, lymphoma, and myeloma. BMT replaces damaged or diseased bone marrow with healthy donor cells and—because of the ability of the donor immune cells to attack the blood cancer cells—it is a potent form of immunotherapy. In many cases, the treatment reverses conditions that were once thought to be incurable.
In addition to its use in blood cancer treatment, BMT and other forms of cellular therapies can be used to custom-tailor a patient’s immune system. Megan Sykes, MD, director of the Columbia Center for Translational Immunology, has demonstrated that combining BMT and organ transplantation can induce tolerance and allow acceptance of the donor organ without the use of long-term immunosuppressant therapy. NewYork-Presbyterian has the largest solid organ transplant program in the country, putting the BMT unit at the forefront of efforts to make these novel combined transplant procedures the clinical standard.
The unit is directed by Markus Mapara, MD, PhD, director of the blood and marrow transplantation program at NewYork-Presbyterian/ Columbia and professor of medicine. In addition to his interest in combined bone marrow and solid organ transplantation, Dr. Mapara is developing new approaches to improve the outcomes of patients undergoing autologous and allogeneic hematopoietic stem cell transplantation by preventing and/or reducing treatment-related complications such as graft-versus-host disease and preventing recurrence of the underlying disease.
Dr. Mapara primarily cares for patients with hematologic malignancies who need blood or marrow transplantation. A particular focus of his research is the ability to perform transplants in patients without matched donors. Approximately 25 percent of people who need a bone marrow transplant have a matching donor in their family. Those without a familial donor must be matched through national and international registries. The chance of finding a match in these registries is about 70 percent for Caucasians. For ethnic minority patients, who are underrepresented in the donor banks, the match rate is much lower. Partial matches from firstdegree relatives, called haploidentical matches, have made BMT possible, especially in patients from ethnic minorities who are unable to find a matched unrelated donor.