Canine Bone Marrow Transplants (BMT)
The bone marrow or stem cell transplant is a procedure that saves thousands of human lives every year. The technology has come full circle and is now available to the dogs that made it possible in the first place. In the last three years, dogs suffering from lymphoma have become eligible to receive the same type of medical treatment as their human counterparts at North Carolina State University; the first university in the nation to offer canine bone marrow transplants in a clinical setting.What is Canine Bone Marrow Stem Cell Transplantation?
Canine transplantation is a way for doctors start curing canine lymphoma. Bone marrow transplantation in people is a standard of care and the doctors at NCSU are now doing the procedure in dogs.
Assistant professor of oncology in NC State's College of Veterinary Medicine, Dr. Steven Suter, received three leukophoresis machines donated by the Mayo Clinic in Rochester, Minn. Leukophoresis machines are designed to harvest healthy stem cells from cancer patients, no donor is necessary. The machines, once used for human patients, are suitable for canine use without modification, as bone marrow therapy protocols for people were originally developed using dogs.
"It's not a new technology; it's just a new application of an existing technology. Doctors have been treating human patients with bone marrow transplantation for many years, and there have been canine patient transplants performed in a research setting for about 20 years, but it's never been feasible as a standard therapy until now. "Dr. Steven Suter - Assistant professor of oncology in NC State's College of Veterinary Medicine - Medical Director, Canine Bone Marrow Transplant Unit
Today, dogs with lymphoma have the rare opportunity to fight cancer and win, and they need your help! Please donate $1, $5, $20 or more to the dogs who have given us so much.
Every little bit helps, and every penny you can spare will help dogs with lymphoma receive the cure they helped create! PLEASE VISIT the BMT PACK to see the dogs that need your help!!
About the Canine Bone Marrow Stem Cell Transplantation procedure:
The goal of the transplant is to replace unhealthy or destroyed bone marrow stem cells with normal bone marrow stem cells. For canine patients with lymphoma, it is possible to use the patient's own marrow stem cells either from the bone marrow or peripheral blood for the transplant. This is called an autologous transplant.
The Conditioning Period
The time immediately before the transplant is known as the, "conditioning period", usually 7-10 days. The purpose of the conditioning is to destroy as many remaining cancer cells in the body as possible. During this time the dogs are treated with a high-dose of a chemotherapy drug called "Cytoxan".
In preparation for the harvesting, the dogs receive a drug called granulocyte colony stimulating factor (G-CSF, Neupogen) for six days to encourage stem cells to leave the marrow and enter the blood. The shots are given exactly 1 week after the cytoxin is administered. Most patients receive the shots upon arrival.
The Transplant
When autologous bone marrow stem cells used, a portion of the patient's marrow is harvested prior to admission for the transplant. The harvesting is done using special human leukapheresis machines under general anesthesia. During this procedure the patient's blood is passed through the leukaphoresis machine that collects the portion of white cells containing bone marrow stem cells. The process is similar to dialysis.
The remaining white cells, red cells and platelets are given back to the patient. Placement of a special intravenous line, called a double lumen pheresis catheter, is necessary for this procedure.
Once these cells are harvested, the patients entire body is subjected to radiation (called total or TBI) to kill any remaining cancer cells left. Following the total body irradiation, the marrow is transfused into the patient.
After the dogs receive radiation their neutrophils drop to zero and they go into isolation. The dream team at NC State checks the numbers every single day, and once the numbers rise it's a good indication that the transplant worked.
Below is a 3D view of the state of the art isolation room at NCSU:
How does the transplant affect the dogs?
The dogs don't seem to be effected by the procedure. People complain of being cold, and dogs usually mimick humans.. NCSU uses plenty of heat support throughout the procedure to keep the dogs warm. Basically they have a catheter in, the blood is taken out, the blood is run through a machine, the cells are harvested and then the everything else is put back into the dog. The dogs don't lose anything during the procedure besides body heat.
What are the cure/success rates for dogs that receive the transplant?
We receive inquiries on a daily basis regarding the success rates of dogs that have undergone the bone marrow transplant procedure. That’s why we turned to North Carolina State University’s trusted staff to fill us in on the statistics and this is what they had to say:
UPDATED: 11/30/10
There is no exact percentage yet, but there is a 60% success/cure rate in humans with Lymphoma receiving this same treatment. It will take at least 2 years to definitively say what the long term success rate is in dogs with lymphoma that have received this treatment.
Fact: 95% of transplant procedures used in humans were tested on dogs first.
As of 11/30/10, NCSU’s BMT Unit has performed the procedure on 32 dogs with Lymphoma. This isn't including the dogs they've treated since 11/30/10.
Number of dogs with B cell lymphoma that have received the bone marrow transplant = 14
- 15 dogs are in remission living cancer free lives!
- 11 dogs have relapsed.
- 3 dogs passed away from causes un-related to lymphoma.
- 3 dogs passed away due in the hospital due to complications.
The longest survivor post-transplant is coming up on 2 years! Other recipients are 1 to 15 months out from the date they received the BMT. Only time will tell the true success and cure rate.
These statistics are incredible! Especially when you consider this; 98% of dogs that receive chemotherapy alone will relapse within 6 months to 1 year.
Angel is in complete remission and with your help she'll stay that way :) Please share our website to inform your friends about the procedure and how you can help these dogs to the cures they helped create! http://www.save-an-angel.org/
For more information about NCSU's Bone Marrow Transplant Unit please click here, http://www.ncsu.edu/featured-stories/innovation-discovery/september-2008/bone-marrow/index.php
How did this treatment become available to dogs?
All of the current human transplant protocols were originally worked out in dogs. Fact: 95% of transplant procedures performed on humans were tested on dogs first! Scientists began testing cancer treatments on dogs 30 years ago, which resulted in many human lives being saved, so they know that it works!
How much does this procedure cost?
For humans, the bone marrow transplant can cost between $100,000 and $250,000 dollars but NCSU is offering it for much less; about one-fifth of the price. Angel's procedure cost exactly $13,000, plus an additional $3,000 for the Neupogen that was purchased before she checked in. That brought Angel's total to $16,000 for the BMT and the Neupogen. This doesn't include the high dose Cytoxan, medications, and 6 months of chemotherapy leading up to the procedure, which cost around $8,000. The goal is to eventually bring BMT’s for dogs into the $10,000 range. We hope to see the BMT being used as a standard of care within the next 5 years.
What about recovery?
Recovery is a long process that must be taken very seriously. The good thing is that we have a lot of information about how long it will take because dogs are mimicking humans every step of the way. Humans usually complain of being tired for up to 3 years. Since everything happens 7 times faster in dogs, they seem to stay tired for 6 months.
When the dog is released from NCSU they are cancer free and on zero medications. They are predicted to lose a majority of their hair from the irradiation and when it grows back it usually comes in white.
The dogs are put back on their regular diet, but adjustments might be necessary if they still show signs of upset stomach. The dogs are required to get plenty of rest and they should only move around when eating, drinking or going potty. The critical bed rest period lasts for 6 weeks.
If the dog receives a transfusion they are required to have their blood drawn once every week until their platelets are over 100,000; healthy numbers are 200,000. Once the dog's platelets are up they see the vet once a month for 6 months. After that it's once every 6 months for 1 year.
If a dog is going to relapse it usually happens within 3-4 months after receiving the bone marrow transplant. Once a dog has been cleared to go home they are considered cancer free, but their final hurdle comes 3-4 months later. If a dog remains in remission w/no releapse after 3-4 months they are home free and considered "cured".
What happens now that we've raised the $16,000 needed to save Angel's life?
Now that we've raised enough money to save Angels life, we'll continue our mission to help dogs win their fight against lymphoma. First we will raise the money to become a 501(C)3. Once we've done that we'll begin donating directly to NCSU's Bone Marrow Transplant Unit to help the next dog that will benefit from this procedure; we won't stop until this procedure is within reach for all of the dogs that can benefit from the BMT.
Our Mission: To help dogs with lymphoma receive life-saving treatments!
There are a number of ways that our donations will help. First, every donation made to NCSU can be earmarked for a specific need. For example, one of the NCSU's donors gives $2,000 each year to the bone marrow transplant unit; this money is earmarked for transfusions. Transfusions are not included in the estimated cost. Some dogs need zero while others need up to 8 or more! Most dogs will only need one during their stay. Each transfusion costs $800 a pop!
When Angel received her transfusion she had an automatic credit to her account in the amount of $200 from the donors who earmarked "for blood transfusions". This was incredibly helpful, especially since it credited a cost that we hadn't factored in. This is just one example. We plan to be in close contact with the upcoming patients and the staff to make sure that your donations are being used where the need is greatest.
We plan to host various fundraisers to help the families of dogs with cancer afford treatments such as chemotherapy, irradiation, medications, surgeries, etc...Frankie's Friends, one of our most treasured Saints, is helping us get our Non-Profit up and running and we are excited for the opportunity to work with and learn from :) The Riedel and Cody Fund is another animal cancer organization that donated to Angel. We are excited about all of the good that will come from our partnership.
We are here to help, we are here to listen and we are here to educate. Please don't hesitate to contact us. Our inbox is always open :)
Who else offers this procedure?
North Carolina State University is the first University in the world that has opened a clinical canine bone marrow transplant unit. This procedure has been done in private practice in Seattle for 4 or 5 years, but this is the first academic institution to offer canine bone marrow transplantation in a clinical setting to treat canine lymphoma. There are several other practices that offer the Bone Marrow Transplant, but we believe NCSU to be the safest option. They are the only ones that have been doing this procedure for the last 4 years and it takes 5 years to write a solid standard. It's impossible to watch a seminar and understand everything that must happen in order to make the transplant successful. We recommend North Carolina State University because they are the only institution that has a proven track record and deep understanding of this procedure.
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