Innovative Research for Precision Bone Marrow Transplants

Bone marrow transplantation (BMT) is a life-saving procedure that replaces diseased blood-forming stem cells with healthy stem cells from a donor. When used in pediatric oncology, these transplants are often a last resort for children who have relapsed from leukemia or lymphoma, and for whom traditional therapy is not working. BMT is not typically used in the early stages of treatment due to the complexity of the procedure and a high risk of complications. In addition to immediate side-effects like infection, low platelet counts, and organ injury, certain patients can experience severe complications five to ten years later, including infertility, organ damage, or risk of developing another cancer. This makes bone marrow transplantation particularly complicated for pediatric patients whose continued growth and development may be especially impacted by these long-term side effects. However, the 60-95 percent success rate of bone marrow transplants makes the procedure a high risk but very high reward option, and one that Columbia is continuing to invest in making safer and more reliable.

At the Columbia University Irving Medical Center’s Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation, Dr. Prakash Satwani has been conducting research on precision bone marrow transplantation for leukemia/lymphoma in order to reduce immediate and late-stage complications without compromising the success rates. With less risk of complications, bone marrow transplantation could potentially be considered earlier and more often for patients with poor prognoses.

Dr. Satwani’s research efforts primarily focus on identifying the risk factors for complications in bone marrow transplants. This includes creating a database of information from all bone marrow transplants done at the center and analyzing patterns of complications. Currently, one of the main potential complications is graft-versus-host disease, where infused donor immune cells attack the tissue of the patient, making the patient sick. By studying data to find safer ways to perform BMT with decreased risk of graft-versus-host, Dr. Satwani is working to avoid additional hurdles in the patient’s healing process.