Stem-cell transplants can boost immune system of blood cancer patients

As he vomited into the toilet after one of his bi-weekly chemotherapy sessions, Keith Oliver’s mom turned to him and asked him if he was still thankful.

He glanced up at her. Are you serious? he thought.

After being diagnosed with blood cancer, it was moments like this — when he was tired of being prodded with needles, when he could not stomach the sight or smell of food as he underwent high doses of chemotherapy — that ended up saving him.

“It’s very easy to be thankful when things are going right,” said 27-year-old Oliver, who admits his mother’s faith-based attitude helped shape his own. “She wanted to make sure that spiritually I stayed in a good place. Something bad could be over in a matter of seconds.”

The constant brushes with frailty and fear lasted two years. Oliver, then 25 and a recent graduate of Florida A&M University’s theater program, had been diagnosed with Stage 2 Hodgkin’s lymphoma. Within a year, his doctor introduced him to a new plan: intense high-dose chemotherapy, followed by a stem-cell transplant.

Last September, he became Patient No. 500 to receive the transplant, mostly used to treat blood cancers like lymphoma, leukemia and myeloma. Doctors at Sylvester Comprehensive Cancer Center at UHealth-University of Miami Health System performed the transplant.

Stem cell transplants can boost or even replace a recipient’s immune system. The transplant process collects stem cells from blood —sometimes a patient’s, other times, a donor’s — and then returns them back to the patient through what looks like a kidney dialysis machine.

Since relocating from Jackson Memorial into Sylvester’s impatient unit, the program has quadrupled over the last eight years. More than 600 stem-cell transplants, like Oliver’s, have been completed since 2011.

“Right now we have the only active transplant center in South Florida,” said Dr. Krishna Komanduri, director of the center’s adult stem cell program. “We’re meeting an unmet need.”

Twenty years ago, the procedure for battling blood cancers was not that simple. Patients were knocked out with anesthesia and rolled into sterilized operating rooms where doctors poked them with enormous hypodermic needles to extract liquid bone marrow.

Now, physicians can trick a patient’s or donor’s body with medications to push stem cells out into the bloodstream and into a machine to be harvested.

After his diagnosis in June 2014, Oliver initially jumped into chemotherapy: 16 rounds, one round every two weeks. When that didn’t kill the lymphoma in his throat and chest, his doctor tried radiation. Three more months without success.

When the chemo and radiation failed, Oliver’s doctors turned to the stem-cell transplant. First, they collected his stem cells. Days later he was admitted to the hospital, where they blasted him with high doses of chemo to eradicate as much as the cancer as possible before transfusing his own stem cells back into his body. Obliterated, his white blood cell count became almost immeasurable.

“His blood counts were very, very low for about 10 days,” Komanduri said. “That’s when the risk of infection is high.”

He spent about three weeks in the hospital — the actual transplant took less than two hours after chemotherapy — while the Sylvester medical team monitored for fever and infection.

“It takes a lot of vigilance. There are a lot of things that can go wrong,” Komanduri said. “The greatest risk of transplants is when the white blood cells are critically low. Close supportive care is very important.”

And then his own stem cells needed to regenerate, a lengthy and slow process.

“You feel weak and your digestive system doesn’t work correctly,” Oliver said. “Your body isn’t breaking down food. So I slept a lot those 20 days in the hospital.”

When his autoimmune system crumbled and he felt helpless to the bone pain, nausea and vomiting, he remembered the worst moments would not last.

“It was just taking everything one day at a time, step by step,” said Oliver, who works in the Broward state attorney’s office. “There are a lot of steps.”

He’s in remission now, and plans to get married in Fort Lauderdale this December.
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stem cell preservation

BSc (Hons) Microbiology

Chief Executive Officer | Biovault Family

Biovault Family CEO, Kate Sneddon, joined Biovault in July 2009 and became Chief Executive Officer in 2016. As health industry professional her experience includes working as a microbiologist and leader at GSK for over 10 years. Her expertise in cord blood banking has been recognised in her awards, features in Parliamentary Review and Parents Guide to Cord Blood, as well as contributions to research with UCL and others.

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