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Bone marrow program begins 21st year
of saving lives
by Mary Helen
MUSC’s first patient to receive a bone marrow transplant, which was
used to treat aplastic anemia, still is alive and thriving in the
Upstate, according to Robert Stuart, M.D., oncology and hematology
professor, founder and director of the MUSC Blood and Marrow (BMT)
M.D., with patient Ryan Post.
Since that first BMT in 1987, almost 800 procedures have been performed
for people facing certain premature death, but many of them cheated
death and now are leading normal lives thanks to the BMT medical team
and technologies at MUSC.
The term bone marrow in BMT has since been replaced by blood and marrow
because of the way procedures have improved resulting in less painful
collection of blood cells rather than extraction from the marrow.
“Stem cells are like bone marrow seeds, and the marrow is like a
factory that makes 1 trillion blood cells a day,” Stuart said. “Most of
the time, we trick the stem cells in the marrow to temporarily leave
and circulate in the blood, “then we collect blood cells via a
technique called leukopheresis,” and transplant the healthy stem cells
into a patient where they eventually replace all of the diseased cells
in the marrow.
BMTs normally are used to treat certain blood disorders, leukemia,
lymphomas and multiple myeloma in adults. In children, BMTs are also
used to treat other cancers, such as neuroblastoma, sickle cell anemia,
and rare congenital disorders. People with BMT have between a 30
percent and 80 percent chance of full recovery and survival.
MUSC’s second largest transplant program, behind kidney
transplantation, BMT has matured and excelled through techniques,
technology and the recruitment of some of the most sought after
clinicians in the country.
“We are currently performing about 70 a year, but our goal is to
perform at least 100 transplants a year,” Stuart said.
On the Children’s Hospital side of the BMT program, the addition of
Michelle Hudspeth, M.D., recruited in July from Johns Hopkins
University, already has translated into a dramatic increase in the
number of children who are receiving treatment here.
“In the half year that she’s been here, there has been a 60 percent
increase in referrals,” Stuart said.
For Hudspeth, it was like returning home to an extraordinary
opportunity. “This is the only center in South Carolina that offers
pediatric BMT,” said Hudspeth, a Greenville native who earned her
medical degree from MUSC. “We also are taking patients from North
Carolina and Georgia.”
Recently, Hudspeth was visiting with young cancer patient Ryan Post,
and his father Charlie, who accepted a job here after retiring from the
“A deciding factor for us moving to Charleston was the program here at
MUSC,” said Charlie Post, who moved to Mount Pleasant from Hawaii to
work for Evergreen.
Ryan’s blood cancer condition relapsed in November, but he was able to
have a BMT from his brother. And so far, his response to therapy looks
good, Hudspeth said.
Meanwhile, Ryan and his father don’t have to feel cooped up. “We love
these big rooms and the great view. Ryan can enjoy playing with his
play station and looking at the [Arthur Ravenel] bridge,” his father
The newly-completed children’s BMT wing in 7B of the Children’s
Hospital includes seven special over-sized rooms, twice the size as
most children’s hospital rooms, which overlook either the Cooper or
Children treated in the Pediatric BMT unit normally stay for at least
30 days to allow the immune system to recover from the radiation and
chemotherapy, which “wipes out their own bone marrow so the new bone
marrow can regenerate in the body,” Hudspeth said. “Their immune system
is still vulnerable, so they have to stay locally, and after that, near
the hospital; and then they have to take immuno-suppressant drugs for
about six months.”
Children who are not local to the area can stay at the Ronald McDonald
House for the first 100 days or longer after they are discharged
from the BMT wing.
As children and adults seek help for blood cancer and other disorders
treatable with BMT, Hudspeth urges more people to register as volunteer
“I donated four years ago for a 52-year-old woman who is now alive and
well and is seeing all of her kids graduate from high school,” Hudspeth
Many myths exist about BMT. Among these myths is that people who donate
blood marrow to family members automatically become registered to
donate to others. This is not true, Stuart said. In fact,
family-to-family donation is completely confidential.
Another myth is that the process of becoming a marrow donor is painful.
“We can get the DNA we need from a cheek swab,” Stuart said.
Meanwhile, becoming a blood marrow donor may cost the donor about $75
to become registered, “because we have to know that you can be depended
upon if you are called,” Stuart said.
Because donors of minority groups, i.e., African- American and Asian
members of the population, are desperately needed, registration is free.
The program is accredited through the Foundation for Accreditation of
Cellular Therapy, and it is the only hospital in the state where a
patient can get a BMT using from the National Marrow Donor Program,
which maintains a database of more than 5 million volunteer donors.
children BMT programs unique in state
MUSC’s Adult BMT program has included autologous, related donor,
unrelated donor, cord blood, and non-myeloablative allogeneic
transplants. MUSC offers the only unrelated blood and marrow transplant
program in the state of South Carolina. Among clinical trials and
advanced technologies employed at MUSC, several include the prevention
and treatment of graft versus host disease.
Within the last year, the program has expanded to include:
- One inpatient and two outpatient nurse practitioners to
provide continuity of care
- Three dedicated bone marrow transplant coordinators that
follow the patient from referral through transplant and recovery
- A dedicated BMT research nurse
- A dedicated bone marrow transplant fellowship beginning in
- An additional physician faculty member beginning in July
The Children’s Hospital BMT program began 10 years ago and is the only
such center in the state. One of the most successful programs in the
Southeast, patients are referred from across the state, North Carolina,
Georgia and Florida. BMTs are done for both malignant and non-malignant
diseases such as sickle cell anemia, immuno-deficiencies, and
adreno-leukodystrophy. All types of BMTs are done, including bone
marrow, cord blood, and reduced intensity transplants. Among its
- Weekly updates on each patient faxed to the referring
- Seven over-sized positive pressure, HEPA-filtered patient
rooms equipped with computers, and full views of the Cooper and Ashley
- Three outpatient nurse practitioners to provide continuity
- Certified oncology nurses
- Three BMT coordinators that follow the patient from
referral through transplant and recovery
- Social Worker and home health/discharge planner
- Weekly patient updated e-mailed to referring physicians
- Weekly multi-disciplinary intake meetings.
Friday, Feb. 22, 2008
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