Madrid, 23 February 2023-. Hematopoietic stem cell transplantation, commonly called bone marrow transplantation, continues to be part of the treatment plan for many patients with different hematological diagnoses, such as leukemia, lymphoma, and multiple myeloma. The new agents and treatment options are not substituting the transplant but rather allowing more people to have access it and, consequently, a potentially curative option.
So, transplantation continues to play a key role in the treatment agenda of someone with a hematological tumor, which is why it continues to be very important in onco-hematological procedures. As Dr. Adolfo de la Fuente, head of the Hematology and Hemotherapy Service at MD Anderson Cancer Center Madrid, explains, "the new treatments allow us to reconstruct schedules, seeing what the role of a transplant should be in each case, on an individual; that is, we can now create new treatment itineraries to achieve a better prognosis”.
In the past, bone marrow transplantation was often the final consolidation of a treatment plan. Currently, based on the needs of each person and the drugs available, new follow-up tools, known as maintenance tools, are being introduced, whose objective is to improve transplant results and prolong the results over time. As explained by the expert, "these new strategies, which include new molecules and combinations, the advent of CAR-T therapies, make it possible to assess when and in what way it is convenient to carry out a transplant on the patient to optimize the outcome."
In turn, the specialist from MD Anderson Madrid stresses that transplant modalities have also advanced towards greater safety and effectiveness.
In 2022, the rate of transplants recovered and pre-pandemic values were exceeded
As of January 1, 2023, in Spain 474,455 bone marrow donors are registered with the Spanish Registry (REDMO). Of these, 21,903 are donors who joined in 2022.1 Thanks to them, the increase in hematopoietic stem cell transplantation (HSCT) from unrelated donors has grown by 29% compared to 2020, the year in which the number fell by 2.5 % due to the impact of COVID-19. In addition, allogeneic transplants have increased by 10% compared to 2021 and 12% if compared with pre-pandemic activity registered in 2019.2
"The donation of hematopoietic progenitors is usually carried out using a cell mobilization and extraction technique called apheresis, they are then frozen for infusion to the patient at the right time," he explains. In the second phase, “conditioning is administered to the patient, which is a treatment that prepares them to receive the donor cells that will nest in the patient’s bone marrow, allowing for healthy hematopoiesis (production of blood cells). This process is safe and involves minimal risks for the donor.”.
Innovative post-transplant follow-up protocol
To help patients with any hematological cancer, MD Anderson Cancer Center Madrid has developed an innovative care protocol so that people with lymphoma or multiple myeloma who undergo an autologous hematopoietic stem cell transplant in Madrid can continue post-transplant care and treatment at a center in their hometown. Before this program, after the transplant, the patient had to spend an average of three weeks in the transplant center, however, thanks to this new protocol, they can complete that period of support in a more familiar environment.
“The goal is for patients to have to travel as little as possible, since this is always something uncomfortable, we want to offer them the chance to be able to get home sooner and with subsequent monitoring of their evolution done by the same team that treated them, but in their hometown”, explains Dr. de la Fuente, who stresses that the comfort of the patient as the aim of the entire project. The objective is to be able to bring the service closer to a greater number of patients, establishing specific agreements and protocols for each of the centers taking part.