New frontiers for bone marrow transplantation

Twenty years ago, Dr. George McDonald made a fascinating observation in a small group of leukemia patients who received a bone marrow transplant.

McDonald noticed that these patients—who also happened to be diagnosed with an inflammatory bowel condition known as Crohn’s disease—no longer showed Crohn’s symptoms. McDonald and colleagues concluded that Crohn’s was caused by abnormalities in the immune system, which is replaced during the bone marrow transplant process.

Dr. George McDonald

The bad news at the time was that the numerous risks associated with bone marrow transplantation far outweighed the benefit of curing Crohn’s disease. So the idea was put on the shelf—until now.

After two decades of improvements and refinement have increased survival rates for bone marrow transplant patients, McDonald is finally examining the procedure as a cure for Crohn’s. Last month, McDonald initiated a study that will enroll patients with severe, treatment-resistant Crohn’s disease.

“The burden of this disease lays heavily on those who don’t respond to any therapy,” McDonald said.

McDonald’s study is only the latest by a growing number of scientists at Fred Hutchinson Cancer Research Center to determine what other diseases might be treated with bone marrow or stem cell transplantation, which were originally conceived to treat leukemia and other blood cancers.

In May, Dr. Hans Peter-Kiem, a member of the Hutchinson Center’s Clinical Research Division, published a study showing that when patients were transplanted with modified versions of their own stem cells, they were able to better tolerate chemotherapy for brain cancer. And last year a $20 million grant was awarded to Drs. Kiem and Keith Jerome to lead a multicenter project that will determine if a similar approach can cure HIV infection.

The new approaches to using BMT by Hutchinson Center faculty highlight just what an important discovery the procedure was when it was developed decades ago.