With the addition of high-dose cyclophosphamide to graft-versus-host disease prophylaxis, simultaneous stem cell/kidney transplantation is feasible for selected patients who have partially HLA-matched donors.
Thomas Spitzer, MD
Thomas Spitzer, MD
Walter Bauer Firm Chief
Professor of Medicine, Harvard Medical School
Departments, Centers, & Programs:
Hematology/Oncology Infusion Unit
100 Blossom Street
Boston, MA 02114-2617
- MD, University of Rochester School of Medicine and Dentistry
- Residency, Cornell University Medical Center
- Fellowship, University Hospitals of Cleveland
American Board Certifications
- Internal Medicine, American Board of Internal Medicine
- Medical Oncology, American Board of Internal Medicine
- Hematology, American Board of Internal Medicine
Accepted Insurance Plans
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My research interests have focused on the development of non-myeloablative preparative therapy for HLA-matched and mismatched donor transplantation for hematologic malignancy. With this approach, mixed chimerism has been reliably achieved and durable remissions have been demonstrated in patients with chemorefractory malignancy. For the first time, using this technique, sustained mixed lineage lymphohematopoietic chimerism has been induced following HLA haploidentical transplantation, and the results of this experience have been published in multiple journals, including Lancet and Transplantation. In addition, I am working closely with the solid organ transplant program in the development of mixed chimerism transplant strategies for the induction of donor specific allotolerance. From this collaboration, the first successful HLA matched donor bone marrow and kidney transplants for end stage renal disease due to multiple myeloma have been performed. Donor specific tolerance following combined bone marrow and kidney transplantation for renal failure in which there is no underlying malignancy has also been achieved with this strategy. The results of this experience, in which sustained specific tolerance was achieved in 4 of 5 patients, were recently published in the New England Journal of Medicine.
Spitzer TR, Delmonico F, Tolkoff-Rubin N, McAfee S, Sackstein R, Saidman S, Colby C, Sykes M, Sachs DH, Cosimi AB. Combined HLA-matched donor bone marrow and renal transplantation for multiple myeloma with end stage renal disease: The induction of allograft tolerance through mixed lymphohematopoietic chimerism. Transplantation 1999 68; 480-484.
Spitzer TR, McAfee S, Sackstein R, Colby C, Toh HC, Multani P, Saidman S, Weymouth D, Preffer F, Poliquin C, Foley A, Cox B, Dumbkowski D, Andrews D, Sachs DH, Sykes M. The intentional induction of mixed chimerism and achievement of anti-tumor responses following non-myeloablative conditioning therapy and HLA-matched donor bone marrow transplantation for refractory hematologic malignancies. Biol Blood Marrow Transplant 2000; 6:309-320.
Dey B, Spitzer T. Current status of haploidentical stem cell transplantation. Br J Haematol 2006 Br J Haematol 2006; 135: 423-437.
Kawai T, Cosimi AB, Spitzer TR, Tolkoff-Rubin N, Suthanthiran M, Saidman S, Shaffer J, Preffer FI, Ding R, Sharma V, Fishman JA, Dey B, Ko DSC, Hertl M, Goes NB, Wong W, Williams WW, Colvin RB, Sykes M, Sachs DH. HLA-mismatched renal transplantation without maintenance immunosuppression. New Engl J Med 2008; 358: 353-361.