Updated: June 28th, 2018
Many of us have heard of bone marrow transplants used in people with cancers. In the last few years, bone marrow transplants have become available for dogs too. Ironically, it was dogs that served as the models for development of the technology in people more than 3 decades ago.
Finally, they are benefiting from the procedure they sacrificed for.
First, let’s look at the benefits. Systemic cancer is hardly ever cured in dogs with conventional veterinary care. Sure, there are exceptions, maybe a couple percent of these dogs. For the most part, we are looking to only make things better for a period of time if we stick to just chemo, surgery and radiation.
With bone marrow transplants, things may change. It is not easy, simple, nor without risks, but if dogs turn out like people, certain lymphosarcoma cases could be looking at a cure rate of roughly 6 in 10. Those are huge numbers, folks.
The cancers treated with the newest approach involve cancerous white blood cells in the circulation. Lymphosarcoma is the most common, with lymphoblastic leukemia also being treated. I am not aware of other cancer types being treated with this procedure currently, but that does not exclude them.
“Bone marrow transplant” is a horrible name for what is going on these days. It does not involve the bone marrow directly, nor does it involve moving it from one location to another. The procedure that is most exciting currently is Autologous Peripheral Blood Stem Cell Transplantation. It takes, very roughly, three weeks of hospital time.
Here is a brief summary of this procedure in an ideal world:
Chemo puts the cancer in remission. Healthy stem cells used to repopulate the bone marrow are harvested. Radiation is used to kill remaining cancer cells. Healthy stem cells are put back in the patient and life is good.
Cost from the College of Veterinary Medicine at North Carolina: about $15,000.
It is not that simple however, as you will see. Let’s look at more details.
Autologous indicates that the patient is the donor, not another dog. The bone marrow is not harvested. Instead, blood taken from a vein that is collected through a port. It is then pumped into a machine which is able to filter out and remove healthy, non-cancerous stem cells.
These stem cells are capable of growing into un-diseased cells that would arise from the bone marrow. The separation of these cells is called leukaphoresis, and the machine is aptly called a leukaphoresis machine. The blood, following stem cell removal, is pumped back into the patient.
However, before all of this can happen, the dog must be primed for the leukaphoresis procedure. Not only must the cancer be in total remission, there can be no infection or exposure to microbes. The patient is treated with antibiotics and the chemo drug cyclophosphamide (Cytoxan) before-hand.
Next, a week of rest is given. Then a drug called Neupogen is used for six days to boost the stem cell levels in the blood before they are collected. On days 6, leukaphoresis is done. Leukaphoresis requires about 3 hours (more or less) of general anesthesia, but does not appear to be painful. The stem cells are stored.
The next day is radiation day. This is also done under general anesthesia. Radiation is performed to try to kill the cancer cells that are resting dormant (in remission) from the chemo. Total Body Irradiation (TBI) is when a dog’s entire body is exposed to radiation.
The idea behind TBI is that if there is cancer in the circulation, like lymphosarcoma, you cannot point the radiation beam at a single tumor since the cells are traveling around the body. So the whole body gets dosed.
Finally, it is time for transfusion of the crop of stem cells from the luekaphoresis procedure done beforehand. They are taken out of storage to be transfused immediately after the irradiation.
Then we have about 2 weeks of supportive care in the hospital. Blood testing is done during this time to monitor the effects of the radiation on the body’s bone marrow cells.
The least costly way, I believe, to get this procedure done for your dog is through the College of Veterinary Medicine at North Carolina State University. Please note that the procedure is done only after a referral from your veterinarian.
Another procedure involving blood donations from a dog’s family (allogeneic stem cell transplants) has been available through Bellingham Veterinary Critical Care in Washington State.
As usual, be your dog’s number one health care advocate!
In the next post, I will examine some of the other details of this procedure. For more on cutting-edge treatments, both conventional and “outside the box” that you can independently research and pursue, check out the Dog Cancer Survival Guide.
Best to all
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