Improving outcomes after stem cell transplantation through better understanding of complex biological systems.
Miguel-Angel Perales MD
Allogeneic Hematopoietic Stem Cell Transplantation (HCT) is a potentially curative treatment for patients with advanced blood cancers. After treatment with radiation and/or chemotherapy, patients receive stem cells from a family member, volunteer donor or cord blood in order to establish a new bone marrow and immune system. Almost 10,000 transplants are performed per year in the US, primarily in patients with acute leukemia, myelodysplastic syndrome, lymphoma and multiple myeloma. Allogeneic HCT is associated with potential complications including immune reactions from the donor’s immune system against the patient’s tissues, called graft-versus-host disease (GVHD), relapse of the underlying cancer, infections and delays in the recovery of the immune system. Research performed at Memorial Sloan Kettering Cancer Center (MSKCC) has focused on improving outcomes in stem cell transplant patients by reducing GVHD, improving immune recovery and a better understanding of the underlying biology of post-transplant complications. We have been able to use next-generation sequencing to gain a very detailed view of how the immune system recovers after transplant and what factors may drive immune recovery. In addition, we have studied patients’ intestinal microbiome to gain further insights into how our treatments affect the normal gut flora in patients, how these changes in gut flora affect patient outcomes and how we may intervene to restore a normal flora. A critical aspect of this type of research is the collaboration with computational biologists to help analyze and interpret the data. The presentation will cover general aspects of Allogeneic Hematopoietic Stem Cell Transplantation, and focus on our use of next-generation sequencing to study complex biological systems that are relevant to human disease.