In the past two decades, bone marrow transplantation (BMT) has become an effective, life-saving procedure for a number of malignant and non-malignant diseases. Opened in 1988, The University of Arizona Medical Center’s Blood and Marrow Transplantation (BMT) Program was the first of its kind in the Southwestern United States. BMT offers hope to many patients whose cancers are otherwise incurable. BMT allows for the safe use of very high doses of chemotherapy and/or radiation therapy in patients whose tumors have developed resistance to standard doses of chemotherapy and radiation. For many patients with hematologic malignancies and solid tumors, BMT is the only curative option.
The BMT Program is affiliated with The University of Arizona Medical Center, the University of Arizona College of Medicine and The University of Arizona Cancer Center. The Blood and Marrow Transplant Program is a full service program, providing transplantation to both adult and pediatric patients the opportunity to have any type of transplant (allogeneic, autologous, and syngeneic) with related and unrelated donor sources to include bone marrow, peripheral blood stem cell, and cord blood donors.
The University of Arizona Medical Center's Program is Southwest Arizona’s only dedicated inpatient BMT unit for both adults and pediatrics. It has 21 beds on the oncology care unit devoted to its patients. The transplant team is comprised of members who have expertise in bone marrow, stem cell, and cord blood transplantation. A multi-disciplinary patient management team meeting is held weekly. The team discussion includes new patients, patients in the evaluation phase, waiting patients, patients in the hospital, and post transplant patients. Treatment strategies and management are discussed. Patient eligibility, protocol availability and suitability are discussed.
In July 2000, The University of Arizona Medical Center's BMT Program became fully accredited by the Foundation for the Accreditation of Cellular Therapy (FACT) for allogeneic and autologous bone marrow and peripheral blood progenitor cell transplantation, including cell collection and laboratory processing. This accreditation process is a voluntary comprehensive standard-setting, inspection, and accreditation program that encompasses all phases of hematopoietic collection, processing and transplant. FACT is a nonprofit corporation developed by the International Society for Cellular Therapy (ISCT) and the American Society of Blood and Marrow Transplantation (ASBMT) for the purposes of self-assessment and accreditation in the field of hematopoietic cell therapy. The major objective of this accreditation process is to promote quality medical and laboratory practice in hematopoietic progenitor cell transplantation.
The National Marrow Donor Program (NMDP) is a non-profit organization based in Minneapolis, Minnesota that facilitates unrelated marrow and blood stem cell transplants for patients with life-threatening diseases who do not have a matching donors in their families. In August 1993, The University of Arizona Medical Center became fully accredited by the NMDP to perform matched unrelated allogeneic bone marrow transplants. University of Arizona Medical Center is also a fully accredited marrow collection center for the NMDP. The NMDP is the only organization that offers a single point of access for all sources of stem cells used in transplantation: marrow, peripheral blood and umbilical cord blood. This organization’s mission is to extend and improve life through innovative stem cell therapies.
Diseases for Which BMT May be Indicated
A. Malignant Disease
- Acute Lymphoblastic Leukemia
- Acute Myeloid Leukemia
- Chronic Myeloid Leukemia
- Hodgkin’s Disease
- Non-Hodgkin’s Lymphoma
- Myelodysplastic Syndrome
- Germ cell tumors
- Ewing or Osteogenic Sarcoma
B. Heritable or Non-Malignant Disorders
- Aplastic Anemia
- Fanconi’s Anemia (heritable BM failure states)
- Maroteaux-Lamy Syndrome
- Common Variable Immunodeficiency
- Severe Combined Immunodeficiency
- Familiar Erythrophagocytic Lymphohistiocytosis
- Sickle Cell Anemia
- I Cell Disease
- Heritable Metabolic Disorders (Gaucher’s, Hurlers)
Types of Transplants Available at UMC
- Matched or Mismatched Unrelated Allogeneic Bone Marrow Transplants
- Matched or Mismatched Related Allogeneic Bone Marrow Transplants
- Matched or Mismatched, Unrelated or Related Umbilical Cord Blood Transplants
- Autologous Bone Marrow or Peripheral Blood Stem Cell Transplants
Team Approach: Optimal Care
The transplant team is comprised of members who have expertise in bone marrow, stem cell, and cord blood transplantation. Multidisciplinary rounds are conducted twice daily. In addition to the attending physician, the program’s nurse practitioners, nurse coordinators, unit nurses, nutritionists, physical therapists, social workers, and pharmacists perform key functions. The resources of clinical pathology, radiation oncology, and virology provide essential services. A multi-disciplinary patient management team meeting is held weekly. The team discussion includes new patient, patients in the evaluation phase, waiting patients, patients in the hospital, and post transplant patients. Treatment strategies and management are discussed. Patient eligibility, protocol availability, and suitability are discussed.
Individualized, Personal Care
Specialized care is given by registered nurses that have completed extensive didactic and clinical training in chemotherapy, radiation, oncology and blood and marrow transplantation. If a patient requires critical care, the care will be provided by a registered nurse in the intensive care unit. Because The University of Arizona Medical Center recognizes the importance of family support in these stressful circumstances, BMT caregivers meet regularly with family members to discuss and evaluate patient progress and prognosis. Social workers provide extensive support to patients and their families regarding psychological and psychosocial needs, housing and financial concerns.