Stanford Report Online

Stanford Report, July 25, 2001
East Bay woman is Stanford's
2,500th bone marrow transplant patient


When Heather Kincaid learned she needed a bone marrow transplant to treat her recurrent Hodgkin's disease, she wasn't sold on the idea. “I said to myself, `There is no way I'm going to do this,'” the Castro Valley mother of four recalled. However, after extensive research and talks with her doctor, Robert Negrin, MD, Kincaid agreed to have the procedure. On Friday, she became Stanford University Medical Center's 2,500th bone marrow transplant, or BMT, patient.

“I'm amazed at how many transplants Stanford has done, and I'm so confident that this is the way to go,” said Kincaid. “The more I've learned about BMTs, the more excited I've become.”

BMTs involve extracting healthy bone marrow stem cells from a donor or the patient. The cells are transfused into the patient following a series of chemotherapy or chemotherapy/radiation treatments. The procedure is used to treat a variety of disorders, including Hodgkin's disease, a cancer marked by lymphoid tissue cells dividing uncontrollably; non-Hodgkin's lymphoma; leukemia; and other hematological disorders. In Kincaid's case, a BMT is the best chance of eradicating her cancer, which returned after a nine-year remission.

Karl Blume (left) talks with Heather Kincaid prior to her bone marrow transplant operation last Friday. Kincaid left the hospital Saturday and will spend the next few weeks recovering in a nearby housing unit. photo: VAS

Stanford's first BMT was successfully performed on a young boy with leukemia 15 years ago; one year later, Karl Blume, MD, a renowned BMT specialist from Los Angeles, was recruited to start Stanford's adult BMT program. Today more than 200 transplants are performed annually and the program, now under the direction of Negrin, is one of only nine programs to receive grants and support for clinical BMT research from the National Cancer Institute.

“Our program combines the most sophisticated, state-of-the-art care with cutting-edge research,” said Negrin, an associate professor of medicine. “We've been able to help patients live long, productive, happy lives while contributing to the understanding of the biology of stem cells.”

Due in part to work at Stanford, bone marrow transplants have evolved greatly over the past 15 years. In the past, patients received the maximum tolerable amount of chemotherapy and radiation, faced a high risk of infection and complications, and remained in the hospital for four to eight weeks following the procedure. Today patients receive less aggressive regimens, endure a minimally invasive and quicker procedure, and spend less time in the hospital. Kincaid spent a week in the hospital prior to the procedure. After the transplant, she was transferred to nearby temporary housing where she will be closely monitored.

“The best part of the procedure will be the three to four weeks I'll spend with my husband in the apartment,” said Kincaid. “It will be like a second honeymoon.”

Today's transplants, like Kincaid's, are also more likely to be autologous – meaning the transplanted stem cells come directly from the patient. Autologous transplants have several advantages over other kinds (they minimize the risk of rejection, for example), but this type of transplant was not possible until several years ago. Blume credits this change to the development of techniques that enable doctors to stimulate patients' bone marrow to release stem cells into the blood stream, collect the cells and purify the cells prior to transfusion. Negrin was instrumental in developing these purification technologies.

Both Blume and Negrin anticipate future advancements in bone marrow transplants. “The 2,500th transplant is a milestone, and we should look to the future with the expectation of more improvement,” said Blume, who served as director of the program until 2000. “We expect to see shorter hospital stays, higher qualities of life, and patients being more quickly integrated into their personal and professional lives. And we expect the procedure to eventually be used to treat other diseases.”

Blume and Negrin also look forward to a favorite tradition: the annual reunion of BMT patients. Every summer since 1989, BMT faculty and staff have gathered patients and families at Stanford to share their stories. This year's reunion takes place Saturday.

“The reunion provides an opportunity for patients to return here, celebrate life, express their experiences and see the staff that took care of them,” said Blume. “It is also an opportunity for our team to see that our work has led to a meaningful outcome.”

Blume said Stanford's first BMT patient is expected to attend the reunion and related activities this year – as are the 100th and 1,000th BMT patients.