“New Era for Transplants”: Roswell Park Reports Increased Survival Outcomes One Year Following Allogeneic Transplant

A combination of prophylactic treatment to protect against graft-versus-host disease, reduced antibiotic and IV use, among many other program-wide operational and patient care judgments adopted based on clinical evidence have resulted in a 92.6% survival rate at one year following an allogeneic transplant at Roswell Park Comprehensive Cancer Center.

 “So much has changed in the field in just the past five years,” says Shernan Holtan, MD, Chief of Blood and Marrow Transplant Service at Roswell Park, announcing a new paper published in the journal Transplantation and Cellular Therapy. “It’s a new era for transplants.”

The 92.6% survival rate after one year is a marked improvement from the contemporary national rate of approximately 80%. 

The data reflect the care of patients who received a first-time allogeneic hematopoietic cell transplantation (alloCT) at Roswell Park in 2024 for any indication — blood cancers like various forms of leukemia, myelodysplastic syndromes, myeloproliferative neoplasms or lymphoma as well as noncancerous conditions like aplastic anemia or other marrow-failure syndromes.

Additionally, Roswell Park will now consider transplantation in liquid tumor patients up to age 85 and will consider cells from a donor who is not a perfect match for the patient, further opening up transplantation as an option for more patients.

Creating a new standard of care based on evidence

Led by Dr. Holtan in collaboration with Brian Betts, MD, Vice Chair of Strategic Initiatives in Roswell Park’s Transplant and Cellular Therapy Program, and Megan Herr, PhD, the new paper provides evidence that operational consistency and deliberate donor selection strategies may significantly improve outcomes for patients receiving this potentially curative therapy.

By adopting new practices, including reducing the amount of IV fluids and antibiotics administered to patients, increasing exercise and focusing on nutrition, and allowing patients who are healthy enough to return home from an in-patient setting as early as 28 days post-transplant, the results greatly surpass historical benchmarks for transplantation.

“Historically, it has taken 17 years for new evidence, once it’s published, to make it into standard medical practice. We didn’t want to wait 17 years to make all of these changes. We sat together, we looked at the current data, and we made changes in literally every aspect of the transplant procedure, including the conditioning regimen, the GVHD prophylaxis, infection, all the supportive care, everything. Everything was updated to what we knew was the most modern evidence.”

Cost- and time-saving strategies to improve outcomes, quality of life

This resulted in “hundreds of small changes,” which not only provided better outcomes but saved both patients and Roswell Park time and money. Dr. Holtan anticipates the streamlined procedures will make transplants available to even more patients who might have had financial barriers to accessing this care in the past.

“We reduced the expenditure for drug costs alone by about half of what it used to be,” she says. “Not every reduction in medicine has to come from a new drug or new technology.”

“The next frontier”

There remains work to be done, Dr. Holtan says, and that involves getting patients home faster, allowing them to heal at home.

“That is the next frontier, really minimizing the travel burden and the costs that are associated with getting a transplant. If we can get patients home sooner, back to their local hematologist, share the care and help support them along the way, that will substantially move the needle” toward making the potentially curative therapy more accessible to a wider range of patients, she says.