Episode 168: Advances in Blood & Bone Marrow Transplants and CAR T-Cell Therapy, with Marcos de Lima

The OSUCCC-James has one of the largest and most comprehensive blood and bone marrow transplant (BMT) and cellular therapy programs in the country, led by Marco de Lima, MD. “You want to cure everyone, period and we work toward that,” de Lima said, as he explained what drives him to find better treatment options for patients. “That’s the motivation and the only currency that matters, and that’s helping people.” Dr. de Lima described three new programs designed to help patients in Ohio and beyond: providing bone and blood marrow transplants (BMTs) and chimeric antigen receptor (CAR) T-cell therapy on an outpatient basis; engineering the genetic modifications of the cells used in CAR T-cell therapy inhouse; and a partnership to expand cellular therapy programs in Brazil. In the CAR T-cell process, T cells (the cells that fight cancer) are removed from a patient and reengineered in a lab to make them more efficient in recognizing and killing cancer cells. They are then put back into the patient to do their job. In the past, patients were admitted to the James during BMT and CAR T-cell treatments “and their stay was three to five weeks, in relative isolation,” de Lima explained, adding that “our ability to prevent infections, safer chemotherapies have set the stage where we don’t have to admit some patients … We will continue to offer inpatient options but will expand the option of coming here daily instead of being admitted to the hospital.” About 20 patients have undergone CAR T-cell treatment on an outpatient basis already. “Of these, 40 percent never needed admission to the hospital and the other 60 percent had their admission times dramatically reduced,” de Lima said. “We want to increase the percentage who will never see the inside of a hospital.” In the past, it took up to two months to send and receive back a patient’s re-engineered T cells from labs located throughout the country. “That’s too long,” de Lima said and then explained that the OSUCCC – James can now re-engineer the T cells inhouse. “We’ve currently treated 14 patients in a clinical trial and it’s taken us seven days from collecting the cells to giving them back to the patient,” he said. Dr. de Lima also described a partnership with Caring Cross (an organization devoted to providing medical services to underserved populations around the world) and Brazilian health officials. Members of de Lima’s team at the James will provide the technical expertise and training to create mobile clean rooms in Brazil that will re-engineer cells for CAR T-cell treatment. “This is a very ambitious program to provide CAR T-cell for free within the Brazilian healthcare system,” de Lima said.