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Bone marrow program marks new era for cancer care

August 05, 2021 | Kristina Lindgren
Dr. Stefan O. Ciurea, director of the UCI Health Hematopoietic Stem Cell Transplantation and Cellular Therapy Program, stands in the corridor outside the bone marrow transplant wing of UCI Douglas Hospital.
Dr. Stefan O. Ciurea directs the Hematopoietic Stem Cell Transplant and Cellular Therapy Program, the first adult bone marrow transplant program in Orange County. Photo by Jared Novakovich/UCI Health.

A little more than a year after performing Orange County’s first adult bone-marrow transplant, the UCI Health Hematopoietic Stem Cell Transplant and Cellular Therapy Program is running in high gear, conducting clinical trials, opening a specialized outpatient center, planning for a stem-cell processing lab and — most important — providing lifesaving transplants to more than two dozen patients so far.

“We are now a full-fledged transplant program and seeing very good outcomes,” said Dr. Stefan O. Ciurea, director of the program at the UCI Health Chao Family Comprehensive Cancer Center, the only Orange County-based comprehensive cancer center designated by the National Cancer Institute.

“We started from scratch a year ago, and we now offer all types of transplants,” he added. “We have a full staff and a new outpatient center where our patients can receive their infusions safely.”

The program also heralds a new era for research and innovative treatment options for patients with blood and other cancers, including clinical trials using genetically engineered T-cells and, eventually, natural killer (NK) cells. Both are blood cells that play a vital role in the body’s immune response to pathogens.

Breakthrough therapy

Called CAR T-cell therapy, T cells isolated from a patient’s blood are modified to produce chimeric antigen receptors (CARs) to find and destroy cancer cells carrying the antigen.

“It’s a breakthrough treatment that can achieve impressive results when infused back into patients,” said Ciurea, a nationally regarded hematologist who was recruited from MD Anderson Cancer Center last year to lead the UCI Health program.

Transplanting hematopoietic stem cells — immature cells produced in bone marrow — requires considerable expertise and specialized facilities. The UCI Health program has a trained transplant team of physicians and nurses, radiation oncologists, transfusion specialists, pharmacists and extensive support personnel. 

Resetting the immune system

Since May 2020, two dozen patients have received stem cell transplants, about half getting their own (autologous) stem cells and half getting donor (allogeneic) cells to reset their immune system or build a new one to fight their disease.

Treatment usually begins with patients receiving high doses of chemotherapy, often with radiation, to kill any remaining cancer cells as well as bone marrow stem cells. Stem cells are then infused to replace those that have been destroyed. Transplanted cells settle in the bone marrow to make healthy new blood cells.

“By its nature, this is a very risky treatment with many components,” Ciurea said. “We have to collect the stem cells, then process and store them in a specialized cell therapy lab.”

That’s why stem cell transplants are typically performed by academic health systems such as UCI Health.

Care close to home

Because these patients usually need to be hospitalized for about a month and have frequent follow-up visits, Orange County’s first adult bone marrow transplant program has been a boon for patients and their families, who no longer need to travel to Los Angeles or San Diego for care.

Ciurea and his colleagues have ambitious goals. In the months ahead, they hope to receive full accreditation for the program, build a cell processing lab, offer CAR T-cell therapy as a standard of care to patients with advanced lymphoma and leukemia, and begin clinical trials with enhanced and activated NK cells.

“I’m very excited about the future,” he said. “This is a new era for cancer care in Orange County.”

To learn more about the program, call 714-456-8000.

 

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