HEMATOPOIETIC (hem"ah-to-poi-et'ik) PROGENITOR CELL TRANSPLANT
Hematopoietic (blood-forming) progenitor cells (HPC), stem cells, bone marrow cells, and peripheral blood stem cells are all names for the cells found in the bone marrow and are known as the "parent" cells from which all other blood cells develop.The three main types of bloods cells are the red blood cell, white blood cells and platelets.

A special treatment, progenitor cell transplant, consists of high doses of chemotherapy, with or without radiation therapy, and progenitor cell infusion.The high dose treatment is such that the bone marrow is severely affected.

Hematopoietic progenitor cells are collected from the bone marrow or blood of the donor and given to the patient who received high dose therapy.The cells help their bone marrow and blood recover from the high dose therapy.

Throughout the remainder of this information the procedure will be referred to as HPCT (hematopoietic progenitor cell transplant).

Progenitor cell transplant may be offered to people who have certain cancers or non-cancerous disorders that may be cured, or where the progression of the disease may be delayed.

Some of the cancers that may be treated with HPCT include blood related cancers and solid tumors such as:

• Acute and chronic leukemia and myelodysplastic syndromes
• Non-Hodgkin's lymphoma and Hodgkin's Disease
• Multiple myeloma
• Breast cancer
• Neuroblastoma (a type of brain tumor usually found in children)
• Ovarian cancer and testicular cancer
• Wilm's tumor and sarcomas (cancer of the bone)
• Some types of lung cancer
• Melanoma (a type of skin cancer)
• Renal cell carcinoma (a type of kidney cancer)

Non-cancerous disorders that may be treated with HPCT include:

• Severe aplastic anemia
• Sickle cell anemia

Autoimmune disorders:

• SLE (systemic lupus erythematosus)
• Multiple sclerosis
• Rheumatoid arthritis
• Some disorders where a person's immune system can't fight infections
• Some hereditary disorders

New indications for transplants are occurring all the time. We are looking at new frontiers.

Progenitor cells are obtained from the bone marrow, peripheral blood, or umbilical cord blood.

These progenitor cells can be obtained from voluntary donors (allogeneic transplant) or from the patient (autologous transplant).Transplant, infusion/reinfusion, or rescue may be used interchangeably depending on the purpose of the treatment.

A peripheral hematopoietic progenitor cell transplant (HPCT) differs from a bone marrow transplant in that the progenitor cells are collected from the circulating blood. The progenitor cells are "mobilized" (made to move) from the bone marrow into the circulating blood by giving either chemotherapy with a type of growth factor or the growth factor alone. This collection process can be done in an outpatient setting, with little of no discomfort and recovery is faster than from a bone marrow transplant. This method of obtaining progenitor cells is gaining in popularity.

With "bone marrow" transplant, the donor has some liquid marrow removed from the iliac crest, the bones near the hip. Usually this can be done in an outpatient setting. The donor usually has general anesthesia for this procedure.

The progenitor cell transplantation program of Marshfield Cancer Care and Saint Joseph's Hospital/Ministry Health Care performs autologous peripheral HPCTs. It is an Eastern Cooperative Oncology Group approved Transplant Center and was the first in Wisconsin to be accredited by the Foundation for the Accreditation of Cellular Therapy (FACT). It also met the requirements for accreditation by the American Association for Blood Banks for Human Progenitor Cell Processes. The program is a participating team member with the Autologous Bone Marrow Transplant Registry/International Bone Marrow Transplant Registry to evaluate response and survival after transplant.

FACT is a non-profit corporation developed to set standards to inspect and accredit all phases of blood and bone marrow transplantation, including the collection of cells, processing and the actual transplant. As of August 2002, about 100 centers had been accredited out of over 200 performing transplants in the country. FACT accreditation is going to be a requirement to participate in National Institutes of Health studies and by participating in these studies we can pool data and reach conclusions sooner.

The accreditation means patients will have access to more national studies using high dose treatment and transplant.

The multidisciplinary team at Marshfield includes the person being treated and family, a program medical director, other transplant and consulting physicians, program manager, case coordinator, blood banking specialists, nurses and nurse practitioners, occupational and physical therapists, spiritual service staff, social workers and dietitians.

WHERE DO I GO WITH QUESTIONS?

You can contact either the Transplant Coordinator, Darlene Bortz RN, OCN at 715-387-7980 or Ione Miedema, RN, MSN, AOCN, Transplant Program Manager at 715-387-9871.