“Our Transplant Program is One of The Largest Programs in The United States”
Nationwide Children’s Hospital is one of the largest pediatric hospitals and research institutes in the United States. It is consistently ranked as one of America’s top 10 children’s hospitals by U.S. News & World Report, the recognized authority in United States hospital rankings. Dr. Abu-Arja is the clinical director of the Blood and Marrow Transplant Clinical Team and a hematology/oncology/BMT specialist at Nationwide Children’s. She is active in clinical research to advance treatment options for patients requiring bone marrow transplants and specializes in transplants for children with immune and metabolic disorders.
What types of patients may be seen by a blood and marrow transplant (BMT) specialist?
Blood and marrow transplant specialists see patients with blood cancers that typically don’t respond to standard chemotherapy regimens. We also see many patients with genetic and blood diseases, such as thalassemia and sickle cell disease. Patients with metabolic and immune disorders detected on newborn screening tests are also managed by the BMT team.
What other specialties do you collaborate with most often for patient care?
The care of a BMT patient requires a multidisciplinary approach. We primarily collaborate with infectious disease physicians and the pain management team. The exact range of other specialties depends on a patient’s condition and unique health needs, but we often work with specialists in physical therapy, genetics, psychology, endocrinology and fertility preservation, gastroenterology and nephrology.
What makes Nationwide Children’s Blood and Marrow Transplant Program different?
The transplant program at Nationwide Children’s is one of the largest programs in the United States and is highly ranked. We are a National Marrow Donor Program Transplant Center, and we are accredited by the Foundation for Accreditation of Cellular Therapy.
We have an excellent group of clinical physicians and physician-scientists that have a great deal of experience in managing very complex patients. The advanced practice nurses, nurse clinicians and support staff are very knowledgeable and experienced, and they provide excellent personalized patient care.
How does your team manage international patients, especially regarding follow-up care and survivorship once they return home?
We are fortunate to have the support of the Global Patient Services team to help us take excellent care of our many international patients. We prepare for their return home in advance, to ensure a seamless transition with the local treating team. Then we continue to communicate with the local physicians and families as needed.
How are the fields of bone marrow transplant and cellular therapy related?
Bone marrow transplant (BMT) is a form of cellular therapy, which is a broad field of treatments that use living cells to treat disease, including cancer and genetic disorders. Some cellular therapies—including BMT—can use the patient’s own cells, but in many cases immune cells are taken from healthy donors and given to the patient to help them fight their disease. In the lab, cells can be grown to high enough numbers to be effective, selected to improve function or reduce side effects, or altered to give them new function. Cellular and gene therapies are sometimes combined to correct mutations, or to reprogram immune cells to identify and attack abnormal cells before they are reintroduced to the patient. The fields are highly integrated, and BMT is sometimes considered the “original” cellular therapy.
What does the future of bone marrow transplant in pediatrics look like?
I believe we have a great future ahead for this field of medicine. We will be treating more patients with BMT and growing the bone marrow donor pool with the advancement in haplo-identical transplants. I think we can also expect to see much more precision medicine, graft engineering and gene therapy that will expand treatment options for our patient population. All of these advancements will certainly come with continued improvement in supportive care for our young patients, to make sure that their outcomes are optimized and they are as comfortable and healthy as possible for the long-term.