As leaders in hematologic oncology, stem cell, and bone marrow transplantation and immunotherapy, Duke Cancer Institute’s Hematologic Malignancies and Cellular Therapy (HMCT) disease group is internationally recognized for its novel approaches to treating leukemia, lymphoma, myeloma, and other life-threatening blood-related cancers.
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We promote health and improve lives by preventing, diagnosing, and treating blood cancers through integrated, innovative, and holistic patient care, education, and research. We offer a broad selection of treatment options, including access to national and investigator-initiated clinical trials. More Information
The Duke Hematologic Malignancies & Cellular Therapy research program conducts basic, translational, and clinical research. The overall goal is to improve outcomes for patients with hematologic malignancies. We strive to build on and extend the current knowledge in the fields of leukemia, lymphoma, myeloma, hematopoietic cell transplantation, and immunotherapy, and to develop and implement novel strategies for improving therapeutic results in these patients through a collaborative and integrated approach involving all the investigators in the program.
Our research program can be broadly divided into the following research areas:
Basic research into the tumor microenvironment, bone marrow niche
Basic understanding of immunity, both innate and adaptive
Genomics, including a genomics core
Cellular therapies such as hematopoietic stem cells, adoptive immunotherapy with selected T cells, NK cells, dendritic cell vaccines, gamma delta T cells
Graft-versus-host disease and graft-versus-leukemia effects
Cell signaling pathways in normal and tumor cells
Specific Aims
To understand hematopoietic stem cell biology and optimize stem cell graft for allogeneic and autologous stem cell transplantation;
To understand the basic biology of graft versus tumor (GvT) and graft versus host disease (GvHD), and to improve GvT without significant GvHD;
To understand the biology of T, B and NK cells and develop novel immunotherapeutic strategies;
To develop genomic signatures for hematologic malignancies and understand mechanisms underlying leukemogenesis or lymphomagenesis;
To design and execute novel Phase I and Phase II clinical trials in hematologic malignancies based on novel laboratory discoveries within the program.
Focus Areas
Hematopoiesis
Immunity
Leukemogenesis & Lymphomagenesis
Clinical Trials
Clinical Trials Results
As a complement to our research efforts, there is also a robust clinical trials office with over 100 active clinical trials specific to hematologic malignancies and transplantation. These range from phase I “first in humans” to randomized phase III studies.
These trials range from securely storing your medical information in an outcomes-reporting registry, to sample repositories, and to national clinical trials and investigator-initiated trials designed to prevent, detect, or treat your underlying disease with the most advanced treatment methods.
Your participation may help you and others in the future.
Some of these trials are only offered at the Duke Cancer Institute. As a result, we offer a broad selection of treatment options to our patients, including some who are not considered candidates for treatment elsewhere. Your participation in a clinical trial may help you and others in the future.
For decades, bone marrow transplantation has saved the lives of patients with blood cancers or other inherited or acquired bone marrow diseases. But today, it’s helping more people than ever because medical advances have made the procedure feasible for more patients.
Bone marrow is spongy tissue in our bones that houses the blood stem cells that give rise to red blood cells, platelets, and the workhorses of the immune system, white blood cells. In a bone marrow transplant, stem cells from healthy bone marrow or blood are infused into a patient to do the work of producing blood cells. Patients with certain blood cancers like lymphoma may need a transplant if the chemo or radiation necessary to kill their cancer also kills their bone marrow. In other cases, the recipient’s bone marrow stem cells may be producing blood cells, but those cells aren’t up to the task of recognizing and killing cancer and need to be replaced with stem cells from a healthy donor.
The transplanted cells can come from the patient (collected ahead of time) or from a donor. In the past, patients in need of a transplant had to have a matched donor, meaning that recipient and donor had the same immunologic proteins, called HLA. Otherwise, the donor cells would launch an immune attack on the recipient’s body.
Over the last few decades, researchers have made significant progress in discovering how to perform transplants using donated cells that aren’t a perfect match. Furthermore, stem cells can now be harvested not just from bone marrow but from blood and umbilical cord.
“More patients can benefit from transplantation now because there are more donor options,” said Edwin Alyea, MD, the chief medical officer of the Duke Cancer Institute. “And we can now offer reduced intensity transplants, with lower-dose chemotherapy, to patients who were previously not eligible because of age or other medical problems.”
Former patient Kameron Kooshesh speaking at his 2022 Harvard-MIT Health Sciences and Technology graduation.
In 2006, 12-year-old Kameron Kooshesh temporarily moved from California to Durham with his parents so that he could get a bone marrow transplant with Duke’s Joanne Kurtzberg, MD. He had just undergone three years of chemo for acute lymphocytic leukemia, and his cancer had returned. His mom researched pediatric bone marrow transplant programs nationwide and chose Duke for her son.
Kooshesh quickly bonded with Kurtzberg and others on his team, from physicians to nurses to case managers. “They knew me and my family so well,” he said. “We trusted them as we would a family member. Duke felt like my home.”
Kooshesh’s bone marrow transplant initially went well, but he developed severe graft versus host disease (GVHD) that didn’t respond to standard treatment. Kooshesh knew of some other kids who had died from GVHD and wondered if the end had come for him.
>Kurtzberg was aware of a drug that might help, but it was still in clinical trials. She won a compassionate-use authorization from the Food and Drug Administration. “Just a couple of infusions of this drug, and I was cured,” he said, “truly cured.” Kooshesh believes he wouldn’t have gotten that drug if he’d been treated at another institution. “Dr. K. is absolutely unbelievable,” he said. “She has a mastery of basic science and clinical and translational medicine that few others have.”
Kooshesh graduated from Harvard Medical School in 2022 and is now a resident in internal medicine at Massachusetts General Hospital. He plans to devote his career to improving stem cell transplants and reducing GVHD.
“I now do the exact kind of research that served as the basis for the drug that saved my life,” he said.
Ovester Grays, athletic director and head women’s basketball coach at Hillside High School in Durham, North Carolina, was diagnosed with mantle cell lymphoma in 2019. Through his nine months of treatment, his entire care team at Duke reassured him. “I was confident about the facts, but the emotional and the mental was nurtured every single step of the way. And it changed my life,” he said. “I’ve told my family if I’m every seriously sick, take me to Duke Hospital. They’re some of the best trained medical treatment personnel in the world. So they mean the world to me.”
When Alexa Balthazar was diagnosed with leukemia at age 28, she ultimately needed a bone marrow transplant. Knowing that her transplant physician, Mitchell Horwitz, MD, had a plan was very encouraging, but she still faced a whirlwind of emotions. Teen and Young Adult Oncology Program nurse navigator Jackie Balliot, BSN, RN, OCN, was there to help. She made several referrals, including connecting Alexa to medical family therapist Geoffrey Vaughn, LMFT, ATR.
“What you go through is traumatic, and to be able to talk with someone who is not a family member or friend about very serious topics was helpful for me,” Balthazar said. In May 2023, she celebrated her one-year transplant birthday.
As the 2023 Annual Meeting of the American Society of Clinical Oncology (ASCO) was wrapping up this week, Chief Patient Experience and Safety Officer at Duke Cancer InstituteThomas LeBlanc,MD, MA, MHS, FAAHPM, FASCO,was already in planning mode for next year's meeting.
LeBlanc,a Fellow of ASCOwho's been volunteering with the society for a decade, has been designated chair of the ASCO Annual Meeting Education Program Committee.
This prestigious appointment comes as the new president of ASCO, Lynn M. Schuchter, MD, FASCO, pledges to focus her presidential year on “The Art and Science of Cancer Care: From Comfort to Cure” whose key goals include a focus on palliative and supportive care.
"Under his leadership as an expert in palliative care and quality of life, we are developing educational sessions for the 2024 ASCO Annual Meeting that will include presentations by experts in symptom management, palliative care, and how to have effective serious illness conversations with patients about goals of care," said Schuchter, speaking about LeBlanc, inan interview with The ASCO Post.
"Incoming President, Dr. Lynn Schuchter, has chosen a presidential theme that is all about the continuum of care, including palliative and end-of-life care issues as well as exciting curative treatments, so we’ll be working together to integrate that type of content much more across the whole conference than in prior years," said LeBlanc. "Palliative care integration in cancer care has been my life’s work, so I couldn’t pass up the opportunity to infuse it into the world’s largest oncology conference!"
Dr. Christina Gasparetto with her patient,Thomas Goode.
Duke Cancer Institute multiple myeloma specialistCristina Gasparetto, MD, and her patient Thomas Goode, have a candid conversation, in four parts, about the physician-patient journey — from Thomas’ multiple myeloma diagnosis 16 years ago to the present.The journey includes building a strong relationship to support struggles and successes and a path to the future.
This "Mye Journey" series is presented by Duke Cancer Institute and is funded by Multiple Myeloma Research Fund donations.
A special report by Duke Cancer Institute the Department of Pathology, Duke University School of Medicine — as featured in the 2021-22 Department of Pathology Annual Report
On Thursday, April 14, 2022, Duke Cancer Institute clinical providers, researchers, staff, and leadership came together to celebrate the 50th anniversary of the Duke Comprehensive Cancer Center (now called Duke Cancer Institute).
As the DCI 50th kickoff celebration was gearing up on the grassy circle in front of Duke Cancer Center building in Durham, a few patients stopped by the adjacent Seese-Thornton Garden of Tranquility for some respite.
Reproductive endocrinology and infertility specialist Kelly Archarya, MD, and Erin White, MS, IVF lab manager/program manager at the Duke Fertility Center.
A cancer diagnosis brings with it a flood of emotions — sometimes one at a time, often all at once. A patient’s initial questions relate to their type of cancer, course of treatment and most importantly, the likelihood of survival.
What may not immediately come to mind is the possible effect the cancer and its treatment could have on the patient’s future ability to have children. Just 20 years ago, this was rarely considered. Then cancer survival rates were lower, and the technology to preserve future fertility was not readily available.
Today, a novel collaboration between the Duke Cancer Institute’s (DCI) Supportive Care & Survivorship Center and the Duke Fertility Center is helping cancer patients' family-dreams come true.
READ IN THE WINTER 2022 DUKE OBGYN MAGAZINE
DEVOTION At the heart of Peggy Alexander’s circle of love and support is Peggy’s husband Lovest Alexander, Jr., MHS, PA-C, and her daughter Paula Borden, PhD, MA who's followed Peggy's footsteps into higher education leadership. The three of them had a chance to relax on a recent family trip to Virginia Beach.
“Peggy is lucky to have the best family support I could hope for. I wish I could clone them for my other patients,” says Shelby Bettony, PA-C.
Peggy Watson Alexander, 73, is an early riser.
“Listen, five or six o'clock, sometimes four o'clock, it's like, “Okay, what are we going to do this morning,” she laughed. “My husband Lovest is not a morning person. I don't even know how we've stayed together all these years, because he definitely does not like getting up early in the morning, but I do, I enjoy it.”
It's Peggy's nature to always be on the move.
Years ago, when she worked at North Carolina Central University (NCCU), she and a colleague would go to work extra early in the morning just so that they could walk around campus before they started their day.
“We did that for many, many years,” recalls Peggy. “You’re not only walking to heal the body, but the world is at peace early in the morning… And it helped me to be at peace with myself.”
Patients diagnosed with leukemia, lymphoma or myeloma often times undergo a stem cell transplant to combat their cancer. Yet, the Adult Blood and Marrow Transplant (ABMT) Program and the Hematologic Malignancies Program were both housed in different locations on the Duke University Hospital campus. That all changed with the expansion of North Pavilion.
“Our services used to be fragmented," said Gabriel Alcantara, MBA, administrator for the Division of Hematologic Malignancies and Cellular Therapy. “The new Duke Blood Cancer Center at North Pavilion allows us to care for our patients in an enhanced, multidisciplinary fashion through the entire care continuum – from initial diagnosis, through treatment and on to survivorship – all in one location."
Providers from both programs are now in one location, which also frees up 14 exam rooms and 14 infusion chairs in the Duke Cancer Center. The Blood Cancer Center is located on the first floor of North Pavilion in what was previously the ABMT Clinic.
Patient appointments began transitioning to the new location in March with all patients being seen there as of May 3.
The space includes:
33 exam rooms
60 treatment chairs
a specialty and retail on-site pharmacy
a patient and family resource center and lounge
a meditation room
convenient on-site parking
The new Duke Blood Cancer Center also opens up the opportunity to transition some cancer treatments from the inpatient to the outpatient setting.
Cancer treatments for hematologic malignancies sometimes require daily care or monitoring over a seven day or greater period. With the Cancer Center being closed on the weekends, patients needing such care would require an inpatient admission. In comparison, the ABMT Clinic has always been open 365 days a year for patients undergoing active transplant. With the expansion of the Blood Cancer Center, the new center can accommodate and provide this same level of access to our broader blood cancer population.
“This frees up inpatient beds in the hospital," said Alcantara. “And for patients, they are able to return home and sleep on their own pillow each night."
Construction on the North Pavilion expansion began in August of 2018. The $50 million project funded a 27,000 square foot addition to the North Pavilion and the renovation of 17,489 square feet of existing space in the same building. The space allowed for the expansion of not only oncology, but also pharmacy and surgical services.