Hematologic Cancer Treatment
Treatment for hematologic cancers may involve surgery, chemotherapy, radiation therapy, and/or stem cell transplantation, depending on the type of cancer and its stage. At the NYU Clinical Cancer Center, patients can receive chemotherapy and radiation therapy in the same location. The NYU Cancer Institute is the only National Cancer Institute (NCI)-designated cancer center in New York City to offer radiation therapy in an outpatient facility.
Stem Cell Transplantation for Blood Disorders and Myeloma
Stem cells are immature cells in the bone marrow and bloodstream that mature to become one of three important types of blood cells: white blood cells, which fight infection; red blood cells, which carry oxygen and remove waste products from organs and tissues; and platelets, which enable the blood to clot. Stem cells in the bloodstream, called peripheral blood stem cells, are used in stem cell transplantation.
Chemotherapy and radiation therapy can destroy vital bone marrow cells. Autologous stem cell transplantation-the removal and return of a patient's own stem cells-enables doctors to remove some stem cells before chemotherapy or radiation therapy, store them while the patient receives therapy, and then return them to the patient after treatment to restore the bone marrow's ability to produce blood cells, especially those vital to immunity.
Stem cells are obtained for transplantation through a process known as apheresis.
- Four or five days before the procedure, patients may receive medication to increase the number of stem cells released into the bloodstream.
- During apheresis, blood removed from a patient's vein goes through a machine that removes the stem cells. Apheresis typically takes four to five hours to complete.
- The blood is returned to the patient and the collected stem cells are stored.
- The collected cells may be treated with drugs to destroy any cancer cells that may be present.
- The stem cells are frozen until they are transplanted back to the patient following treatment.
NYUCI stem cell specialists have performed transplantation in patients with Hodgkin's and non-Hodgkin's lymphomas, acute myeloid leukemia, and multiple myeloma, as well as some patients with primary brain cancers.
- In patients with lymphoma, a stem cell transplant is usually done after an initial course of chemotherapy is completed and the patient experiences a first remission.
- Patients with acute myeloid leukemia may undergo stem cell transplantation after a first remission or a subsequent remission following a second or later course of chemotherapy.
- Patients with multiple myeloma may have a stem cell transplant right from the start of their therapy.
The NYU Cancer Institute has a six-bed inpatient unit with positive-pressure filtered rooms, where patients with severe immunological suppression from cancer treatment can be treated in a protected environment. The facility also features a dedicated pharmacy, a nurse specialist with graduate-level oncology training, and a dietitian with experience meeting the unique nutritional needs of patients undergoing intensive treatment for hematological cancers.
The NYUCI is currently in the design phase for a new allogeneic bone marrow transplantation unit (the transplant of bone marrow from a healthy donor to another person), scheduled to open in 2009.