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Orange County's only adult program achieves 200th transplant, takes 'rocket-like' leap to deliver novel cell therapy
July 15, 2024
Orange, California — UCI Health's bone marrow transplant program reached a major milestone, recently performing its 200th transplant procedure.Number Since opening in May 2020, the facility has been providing life-saving care.
The Chao Family Comprehensive Cancer Center's burgeoning program is also expanding access to cellular therapies, including chimeric antigen receptor (CAR) T cells, offering hope to patients with some of the hardest-to-treat blood cancers and solid tumors.
As the only adult bone marrow service in Orange County, the center is also one of the few U.S. programs to transplant hematopoietic stem cells for patients with multiple sclerosis and other autoimmune diseases. Patients with certain solid tumors, such as testicular cancer, also undergo transplant procedures at UCI Medical Center, part of UCI Health.
“This program has grown like a rocket,” said Dr. Richard A. Van Etten, director of the Chao Family Comprehensive Cancer Center and a member of the transplant team.
Van Etten noted that in just under two years, the program has achieved the remarkable feat of being accredited with the National Standard of Excellence for Cellular Therapy Programs, and it is also the only program approved by CalOptima Health, Orange County's health insurance plan for low-income adults, children and people with disabilities.
“We started this program so patients could receive these treatments closer to home,” he said, “and now we have patients coming from all over the region and the country.”
Over 200 transplants
To date, the Hematopoietic Stem Cell Transplantation and Cellular Therapy Program has performed more than 200 blood and bone marrow derived stem cell transplants, including 13 procedures for autoimmune diseases, including autologous transplants using a patient's own cells and allogeneic transplant procedures using matched, mismatched and semi-matched (half-matched) donor cells.
“A patient count of more than 200 is quite remarkable, given that most new programs offer only autologous transplants in the first few years,” said Dr. Stephen O. Ciurea, a hematologist-oncologist at UCI Health and professor at the University of California, Irvine School of Medicine, who was recruited from the renowned MD Anderson Cancer Center in Houston to lead the program.
“In just four years, we have become a mature transplant and cellular therapy service, able to perform the full range of procedures associated with our established program,” said Ciurea, who is also a national leader in haploidentical transplants, which make up the majority of the program's allogeneic transplants.
More Treatment Options
The team is also increasingly using FDA-approved CAR T-cell therapies in which a patient's own immune cells are genetically engineered in the lab and then infused back into the patient to attack cancer cells.
Additionally, research teams are enrolling many patients in very promising early-phase clinical trials of CAR T and other cell therapies, including some that stem from discoveries by UCI scientists. Other trials focused on improving transplant outcomes and success rates are also underway, with more expected to begin in the coming months.
“We have some very exciting research going on here, some of which is unique to our cancer center and some of which is only offered at a few other academic medical centers in the country,” Ciurea said.
A difficult procedure
Transplantation of hematopoietic stem cells (immature cells found in bone marrow and blood) can extend survival and cure many patients with high-risk blood cancers, such as leukemia, lymphoma, and myeloma. It is a complex and challenging procedure that requires significant expertise and specialized facilities.
Treatment typically begins with the patient undergoing high doses of chemotherapy (and often radiation therapy) to eliminate any remaining cancer cells, which typically removes the patient's bone marrow stem cells. New stem cells, either from the patient or a tissue-matched donor, are then infused, allowing them to colonize the bone marrow and produce healthy new blood cells.
After a transplant, patients typically stay in hospital for several weeks to allow their blood and immune systems to reconstitute. Their progress and side effects are closely monitored with multiple follow-up appointments.
The UCI Health program has an experienced transplant team that includes physicians, nurses, transfusion specialists, pharmacists and other support personnel, as well as training programs for physicians interested in stem cell transplantation and cellular therapy.
Preparing for growth
To accommodate the rapidly growing number of CAR-T and transplant patients, Ciurea plans to add at least two fellowship-trained specialists to its team, as well as additional staff to run the new processing lab.
The cell processing lab at the medical center in Orange is designed to prepare cellular products for patients, including hematopoietic stem cells and immune cells such as CAR T, for both FDA-approved commercial therapies and cancer clinical trials at UCI Health.
Investigator-initiated trials are also supported by the university's state-of-the-art Regenerative Medicine Manufacturing Center on campus. The Good Manufacturing Practices facility, a series of ultra-clean laboratories and quality control rooms, was built to create next-generation FDA-approved gene and cell products for patient treatment and clinical research.
“The survival rate is very good.”
Ciurea is particularly proud of the program's excellent results and extremely low error rate of 0.8%. International Blood and Marrow Transplant Research Center (CIBMTR) compared to 3% for the benchmark. National Marrow Donor Program In collaboration with the Medical College of Wisconsin, we collect data on all hematopoietic cell transplant procedures.
“The survival rates are very good, and we are confident that this will translate into excellent transplant outcomes.”
He also won the Chao Family Comprehensive Cancer Center – Irvine A large-scale infusion facility will also open, greatly expanding access to outpatient transplant procedures and cellular therapies, while providing patients living in coastal and southern Orange County with a continuum of care closer to home.
“For people in intensive care, being close to home is really important,” he said.
Looking to the future
When the UCI Health-Irvine Medical Complex opens a 144-bed acute care hospital in 2025, it will become the new home for the transplant program, where a more advanced processing lab will provide more opportunities to study new cell therapies.
Ciullea credits the program's sound foundation and rapid growth to “exceptional organizational support” from Van Etten. Dr. Michael J. Stamosdean of the University of California, Irvine School of Medicine, and Chad Lefteris, president and CEO of UCI Health.
“We have an incredibly dedicated team and without them all of this wouldn't be possible,” he said.
“We never imagined we'd be in the position we are in today. We will continue to expand to serve the many patients in need of transplants and cell therapies in Orange County and beyond, and we will continue to develop even more innovative approaches to improve patient outcomes.”
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About UCI Health
UCI Health, UCI Health, one of the largest academic health systems in California, is the clinical enterprise of the University of California, Irvine. The system is comprised of the main campus UCI Medical Center, a 459-bed acute care hospital in Orange, California, four hospitals and affiliated physicians in the UCI Health Community Network in Orange and Los Angeles counties, and ambulatory care centers throughout the region. Recognized as a top hospital by The Leapfrog Group, UCI Medical Center provides tertiary and quaternary care and is home to Orange County's only National Cancer Institute-designated Comprehensive Cancer Center, a high-risk perinatal/neonatal program, an American College of Surgeons-certified Level I adult and Level II pediatric trauma center, a Gold Level 1 geriatric emergency department, and a regional burn center. UCI Health serves a community of approximately 4 million people in Orange County, western Riverside County, and southeastern Los Angeles County. Facebook, Instagram, LinkedIn and twitter.
About UCI Health — Irvine
UCI Health — Irvine is a new medical facility under construction on the north end of the University of California, Irvine campus that will bring the unmatched expertise and best-in-class evidence-based care that only an academic health system can provide to coastal and southern Orange County communities. As part of UCI Health, which includes Orange County's flagship UCI Medical Center, Orange County's only National Cancer Institute-designated comprehensive cancer center, and multiple outpatient clinics, the new 1.2 million-square-foot campus will offer leading clinical programs in oncology, digestive health, neurology, neurosurgery, and orthopedics and spine surgery. The nation's first all-electric, carbon-neutral medical center, UCI Health Irvine is home to the Joe C. Wen & Family Advanced Care Center, a five-story, 168,000-square-foot medical facility that will provide multidisciplinary specialty care for children and adults under one roof, as well as emergency medical services, a children's wellness center, and the UCI Health Center for Autism and Neurodevelopmental Disorders. Opening this summer is the Chao Family Comprehensive Cancer Center and Ambulatory Care, a 225,000-square-foot facility, and in 2025, a seven-story, 350,000-square-foot acute care hospital is scheduled to open.
