Stem Cell and Immunotherapy
The Division of Stem Cell and Immunotherapy is actively developing new cellular and immune based approaches for the treatment of patients with cancer and hematological disorders. We have one of the largest bone marrow and stem cell transplant programs in the southeast United States, and have performed over 3500 transplants. We treat patients with; we administer high doses of chemotherapy with autologous stem cell support as part of integrated care plan for patients with lymphoma and myeloma and offer allogeneic bone marrow and stem cell transplantation for patients with relapsed or high risk acute myeloid leukemia, acute lymphoblastic leukemia, myelodysplastic syndrome and bone marrow failure states. Investigational studies are exploring the role of allogeneic stem cell transplantation for patients with hemoglobinopathies such as sickle cell disease and thalassemia. Active clinical research protocols are defining the optimal strategy to prevent or reduce graft-versus-host-disease while maintaining a graft-versus-leukemia effect.
Since 1978 when the first bone marrow transplant was performed at Emory, the mission of the Bone Marrow and Stem Cell Transplant Program at Winship Cancer Institute, the oldest and largest such program in Georgia, has been to provide curative therapy for patients with cancer using combinations of high dose chemotherapy with bone marrow or blood stem cell transplants. The program performs autologous, related and unrelated donor transplants and to date has performed over 5,000 transplants. The program's physicians are internationally known for research and treatment of blood cancers such as leukemia, lymphoma, and multiple myeloma. Participation in national, international and institutional clinical trials assures that the program offers patients the newest knowledge in stem cell biology and transplant immunology.
Collaborations take place in research and clinical and basic science through a number of national and international organizations, including:
- National Bone Marrow Donor Program
- Fred Hutchinson Research Collaborative for Nonmyeloablative Transplant Consortium
- Multiple Myeloma Research Foundation (MMRF)
- Eastern Cooperative Oncology Group (ECOG)
- Center for International Blood and Marrow Transplant Research (CIBMTR)
For patients seeking more information, please visit the Bone Marrow and Stem Cell Transplant Center webpage at Winship Cancer Institute.
The Emory Personalized Immunotherapy Center (EPIC CPC) is located within the premises of Emory University Hospital Blood Bank. We have refurbished a clinical-grade, fully equipped, high sterility isolation facility. It is designed as an enabling infrastructure to support early phase clinical trials of cell-based therapies where processing of human cell and tissue is required as part of a FDA-sponsored biopharmaceutical study. The facility is to be manned by a team of highly qualified personnel dedicated to the successful implementation and prosecution of personalized cellular medicine clinical trials. The purpose of this designated core facility is to directly support investigator-driven Phase I cell therapy clinical trials at Emory with an emphasis on novel therapies considered to be first-in-human, first-in-Georgia and first-in-child.
As a core facility, EPIC provides a unique resource to the Emory community in assisting the translation of cellular therapies from the bench side to the clinic. The facility possesses all the necessary infrastructure to manufacture cellular therapies under FDA approved good manufacturing practices (FDA cGMP Phase I guidance July 2008) and can supply investigators with cellular material and specialized growth medias to foster the clinical development of novel personalized therapies. This facility was designed to be nimble and adaptable and should be able to support the manufacturing needs of most small enabling cell therapy clinical trials. The highly qualified personnel employed to operate EPIC can also act as resources to assist clinicians and researchers in developing robust translational data to support applications to Emory IRB and INDs to FDA. In addition, these persons will provide scientific input on trial design, regulatory oversight and assist in product development issues related to scale up, release criteria, potency and sterility testing.
Visit Emory Personalized Immunotherapy Center for more information.
Emory has one of the largest myeloma programs in the country; enrolling over 100 subjects a year onto investigational drug trials, evaluating new drugs and new combinations of drugs for myeloma. Preclinical models are utilized to define optimal dose and schedule of novel compounds including combinations and sequences of the newer targeted agents. Genomic analyses of primary tumor samples are defining the genetic heterogeneity of myeloma and using gene expression profiling to optimize treatment. Randomized clinical trials are defining optimal approaches for stem cell mobilization and the role of stem cell transplantation in the management of multiple myeloma.
For patients seeking care for myeloma, please visit the multiple myeloma care web page at Winship Cancer Institute.
Research in the Program for Preclinical Bone Marrow Transplant Models is focused on the development of new transplant methods to improve outcomes of transplantation for patients with relapsed leukemia or lymphoma. Bone marrow transplantation from an allogeneic (not self) donor has the potential to cure relapsed leukemia or lymphoma. However, success is often limited by another relapse or the development of serious complications including graft-versus-host disease (GvHD) and infections. In the Preclincal Models program, clinician-scientists and laboratory-based scientists work together to develop and test new transplant strategies designed to improve graft-versus-leukemia (GvL) effects of transplantation, reduce GvHD, and improve post-transplant immunity to provide better protection from infection. Research topics are based on different aspects of post-transplant immunology, and conducted using cell culture methods and in animal models. We are investigating methods for ex-vivo treatment of donor T-cells that may reduce GvHD activity, and also testing strategies to change the content of donor dendritic cells in the graft, which may in turn alter the immune polarization of donor T-cells to improve outcomes. Other studies are testing the potential utility of several different novel proteins with biological activity that may reduce GvHD and/or improve GvL and post-transplant immunity. Thus, the goals of the Preclinical Models program are to develop and test strategies to improve transplant outcomes, and to provide scientific data that will support translation of these methods to clinical trials.
Visit Waller Lab for more information.
The division of stem cell immunotherapy coordinates care for patients with non-Hodgkin's lymphoma and Hodgkin's lymphoma. Active clinical researched studies are testing and evaluating the safety and efficacy of novel compounds to treat these illnesses. Transplant protocols utilized high dose chemotherapy with stem support for the management of patients with very high risk lymphoma or those patients whose lymphoma has reoccurred after first line treatment. Epidemiological studies are defining the instance of lymphoma in Georgia, and disparities in the management and response to treatment based upon the ethnicity of patients.
The Emory stem cell and immunotherapy division is actively investigating optimal management of patients with T-cell NHL, a disease that typically has had poor outcomes to standard chemotherapy. New drugs are tested in clinical trials as well as new drug combinations and management of patients with cutaneous T-cell lymphoma T1+, T-cell NHL and T-cell NHL NOS. Clinical samples from patients with these rare disease entities are available for preclinical testing including cytogenetic analyses and for gene expression arrays.