Blood and Marrow Transplant and Cellular Therapy team reaches 3,000 patient milestone

The Blood and Marrow Transplant and Cellular Therapy team at MUSC Hollings Cancer Center celebrated a big milestone this week – 3,000 patients treated since the program offered the first transplants in South Carolina in 1987.

Blood and bone marrow transplants – sometimes called stem cell transplants – can be lifesaving for people with different types of blood cancers. They’re also used for diseases like sickle cell anemia and aplastic anemia, known as bone marrow failure.

Michelle Hudspeth, M.D., director of Adult and Pediatric Blood and Marrow Transplantation and Cellular Therapy, said the quickening pace of transplants shows both the expansion of treatment options and the dedication of the BMT and Cellular Therapy team to bringing this therapy to as many patients as possible.

“Indications and options for cellular therapy are growing at a tremendous pace. Our accelerated growth occurred despite the COVID pandemic, which created not only an extraordinary challenge to care for the most immune-compromised patients but also the most difficult time to access the international network for stem cell donors,” Hudspeth said. “Every aspect of delivering cellular therapy has become exponentially more challenging in the last five years. Our growth and outcomes are a true testament to the committed expertise and collaboration of our team.”

For patient Kennedy Golden, 23, the transplant is a new start.

Golden was working as a nurse in the step-down ICU unit at Prisma Health Richland in Columbia when she started having what she called “a year of tummy trouble.” As she and her doctors tried to figure out the cause of her somewhat vague symptoms, she went through a CT scan, an MRI scan and two colonoscopies. But the symptoms grew steadily worse until one day last October, trying to get back to her car after her shift, she simply couldn’t keep going. She ended up being admitted to the hospital, where she learned her bowel had ruptured.

At that point, doctors performed a biopsy. A week later, Golden learned she had intestinal T-cell lymphoma, a rare type of non-Hodgkin lymphoma, which prompted her oncologist in Columbia to refer her to Hollings.

At Hollings, she met with Brian Greenwell, M.D.

 

“It was honestly really scary at first because they say it's a rare intestinal cancer that I have,” Golden said. “But they put it all in perspective for us like, ‘Hey, this is what the plan is. You’re young. You’re otherwise very healthy; we see you doing well.’”

“They told us the whole overarching plan to get to this bone marrow transplant, and they called it the sledgehammer – like chemo is this little nail, and the sledgehammer is the bone marrow transplant that’s going to knock it out,” she said.

Golden had six rounds of chemotherapy at Prisma, from November through March, as her treatment plan progressed toward the stem cell transplant. Through most of it, she continued to work. Her colleagues looked out for her by ensuring she wasn’t assigned to patients with COVID or other respiratory illnesses, but other than that, it felt good to be working, she said.

“I felt so much better. Even being in the throes of chemotherapy was better than the tummy trouble I’d been dealing with,” she said. “It's very refreshing to feel normal, even with things out of whack.”

She then began to prepare for the stem cell transplant.

Autologous stem cell transplant

Golden’s transplant was autologous, meaning that it used her own stem cells instead of a donor’s. This type of transplant avoids graft-versus-host-disease, a complication in which new cells from a donor start attacking the patient’s existing cells.

 

Bone marrow stem cells will mature into all of the different types of blood cells that a person needs, so a patient can receive an autologous transplant only if the cancer hasn’t spread to the bone marrow.

To prepare for the transplant, healthy stem cells are removed from the patient. This can be done in the operating room by removing the cells directly from the bone marrow, but the majority of transplants today use the peripheral blood stem cell procedure instead.

In a peripheral blood stem cell retrieval, the patient gets injections of a protein that prompts the stem cells to start moving out of the bone marrow into the bloodstream. From there, they can be retrieved in a process called apheresis. Blood is removed from a vein, run through a machine that separates the stem cells from everything else and the remaining blood is returned to the body.

The patient then undergoes high-dose chemotherapy that kills off any remaining cancer cells as well as the bone marrow. The peripheral blood stem cells are then infused into the patient, where they will take root, or engraft, and start producing new blood cells.

Outcomes to be proud of

The BMT and Cellular Therapy team recently published its annual quality report for 2023. The report shows how the program has grown in the past few years while maintaining survival rates above the national average.

In 2023, 144 adults received stem cell transplants, compared with 95 in 2018.

And in keeping with MUSC’s mission to bring high-quality care to all South Carolinians, the BMT team transplanted almost twice the percentage of minority patients as the national composite, which Hudspeth said “speaks to our mission of providing access and breaking down barriers.”

“This is an incredible testament in particular to the dedication of our social workers, nurse coordinators and advanced practice providers,” she noted.

Ready to get on with life

Golden appreciated how the two hospital systems worked together to coordinate her care. And she enjoyed seeing all of the different roles of nurses throughout her treatment – perhaps even giving her some ideas for future career directions.

Most of all, she’s grateful for her family’s support.

 

Her mom, Vanessa Golden, is staying in Charleston until the expected discharge date of July 24, while dad, Stewart Golden, is commuting back and forth. Golden’s hospital room is covered in posters and cards from friends and family encouraging her.

“My family has been my everything. They have really kept me on my toes,” she said. “There was not a single point where they weren't there for me.”

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