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Paul O'Donnell, MD, PhD
PaulODonnellMDPhD (Physician - Oncology - Hematology/Oncology (Verified) )| Communities: Non-Hodgkin Lymphoma , Hodgkin Lymphoma , CLL (Chronic Lymphocytic Leukemia) | Answers: 8 |
| Member Since: Jun. 2012 |
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Professional Statement
Dr. O'Donnell is the medical director of the Adult Transplant Service and is also a researcher in the Clinical Research Division at Fred Hutchinson Cancer Research Center, working on leading-edge research using alternative donors for bone-marrow transplantation.
His main interest is bone marrow and stem cell transplantation for the 40% of patients who cannot find matched related or unrelated donors and for whom cord blood or mismatched family donors (haploidentical donors) are suitable alternative donors. Many of such patients are members of ethnic minority groups.
Dr. O’Donnell began his career studying chemistry and later earned graduate degrees in biochemistry and molecular biology. That led to a 20-year research scientist position at Memorial Sloan-Kettering Cancer Center in New York, where he studied retroviruses that cause leukemia in mice.
At the age of 42, Dr. O’Donnell felt the need to become more involved in the study of human diseases. He enrolled in Johns Hopkins School of Medicine where he later pursued an oncology fellowship and then joined the faculty.
He worked at Johns Hopkins for over 10 years and moved to Seattle to join the faculty of the bone marrow transplantation program at the Fred Hutchinson Cancer Research Center/ SCCA in 2001. Subsequently, he became the medical director of the Blood and Marrow Transplant Service, overseeing about 45 medical staff members, attending physicians, mid-level providers, and oncology fellows. He is also a researcher in the Clinical Research Division at the Fred Hutchinson Cancer Research Center, working on leading-edge research using alternative donors for bone marrow transplantation.
His main interest is bone marrow and stem cell transplantation for the 40% of patients who cannot find matched related or unrelated donors and for whom cord blood or mismatched family donors (haploidentical donors) are suitable alternative donors. Many of such patients are members of ethnic minority groups.
Dr. O’Donnell began his career studying chemistry and later earned graduate degrees in biochemistry and molecular biology. That led to a 20-year research scientist position at Memorial Sloan-Kettering Cancer Center in New York, where he studied retroviruses that cause leukemia in mice.
At the age of 42, Dr. O’Donnell felt the need to become more involved in the study of human diseases. He enrolled in Johns Hopkins School of Medicine where he later pursued an oncology fellowship and then joined the faculty.
He worked at Johns Hopkins for over 10 years and moved to Seattle to join the faculty of the bone marrow transplantation program at the Fred Hutchinson Cancer Research Center/ SCCA in 2001. Subsequently, he became the medical director of the Blood and Marrow Transplant Service, overseeing about 45 medical staff members, attending physicians, mid-level providers, and oncology fellows. He is also a researcher in the Clinical Research Division at the Fred Hutchinson Cancer Research Center, working on leading-edge research using alternative donors for bone marrow transplantation.
Professional Info
Credential: MD
Primary specialty: Oncology - Hematology/Oncology
Medical school: Johns Hopkins School of Medicine
Fellowship: Johns Hopkins School of Medicine
Areas of expertise: 1. Hematologic malignancies 2. Allogeneic HSCT from mismatched, related (haploidentical) donors 3. Immunotherapy 4. Acute GVHD 5. Chronic GVHD 6. Palliative Care 7. Stem cell processing
Hospital affiliation: Seattle Cancer Care Alliance
Practice address:
825 Eastlake Ave. E, P.O. Box 19023
Seattle, WA
98109-1023
Practice phone number: (206) 288-SCCA (7222)
Personal Bio (My story)
I want to provide the best clinical care to my oncology patients that is evidence-based. I want the patient to be as well-informed as possible about their disease so that treatment decisions can be shared and realistic.
PaulODonnellMDPhD Activities
Blood or bone marrow transplantation is standard of care for advanced cancers of the blood system (primarily leukemias, lymphomas and multiple myelomas) that have relapsed after conventional chemotherapy or radiotherapy or are considered to be at high risk of relapse after initial diagnosis and therapy. Blood or marrow transplants have not been shown to be effective for non-blood system cancers, e.g., breast cancer.
New answer by PaulODonnellMDPhD (Physician - Oncology - Hematology/Oncology (Verified))
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11 months ago
The main risks involved in umbilical cord blood transplantation are infection due to the immaturity of the donor’s immune system, organ toxicity and GvHD (as described inhttp://talkabouthealth.com/what-have-been-the-success-rates-and-what-are-the-risks-of-having-a-allogeneic-hematopoietic-cell-transplantation-hct). In 2012, the success rates after transplantation from matched related or unrelated donors is essentially the same and emerging data suggests that success rates after transplantation from alternative donors such as cord blood or haploidentical family members may also be comparable.
New answer by PaulODonnellMDPhD (Physician - Oncology - Hematology/Oncology (Verified))
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11 months ago
Other than the difference in the source of the stem cells and immune cells from umbilical cord blood, there is no difference in the remainder of the transplant procedure compared to blood or bone marrow grafts from related or unrelated donors. This is true for both ablative and non-ablative conditioning therapies.
New answer by PaulODonnellMDPhD (Physician - Oncology - Hematology/Oncology (Verified))
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11 months ago
The small amount of blood contained within the umbilicus after birth contains blood stem cells with high growth potential and also immature cells of the immune system. Around 1990, it was realized that umbilical cord blood could serve successfully as a donor in allogeneic transplantation. The first umbilical cord blood transplants were performed within family members and some people continue to save cord blood for that purpose. More commonly, women donate their umbilical cord blood to banks where it is typed and frozen for future use by unrelated recipients. Currently, there are about 500,000 units of umbilical cord blood stored in blood banks worldwide. Because the immune cells in a cord blood unit are immature, the degree of matching can be less that perfect without causing severe GvHD. However, because the number of cells present in a cord blood unit is small, transplants were initially restricted to children since the number of cells per kilogram of recipient weight is critical to the “take” of the cells. More recently, it was realized that more than one cord blood unit could be combined to compensate for the cell dosage problem allowing cord blood transplants to be performed in adult patients.
New answer by PaulODonnellMDPhD (Physician - Oncology - Hematology/Oncology (Verified))
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11 months ago
Success of allogeneic transplantation is measured in disease-free survival (DFS), i.e., absence of relapse of the patient’s disease or of death due either to underlying disease or complications of the transplant procedure. Relapse remains the most significant cause of treatment failure and is the focus of much current research in the field. Death due to transplant complications has declined steadily over the past 2 decades due to improved supportive care. Thus, there is a much lower incidence of infections, organ toxicity and graft-versus-host disease (GvHD), the unwanted side effect of the donor’s immune response which results in attack of normal tissue in addition to cancer cells. GvHD can occur early (usually within 30-60 d) or late (after 3-6 months) after transplant and remains one of the most significant risks of the procedure. GvHD can affect the skin, liver and GI tract of the patient and requires use of drugs which suppress the immune system. Since similar cells of the immune system are involved in the beneficial anti-cancer effect and in GvHD, a delicate balance of immunosuppression is required. GvHD usually can be controlled and the immunosuppressive drugs withdrawn but if it is resistant to control (in about 5% of patients) there can be a fatal outcome. DFS depends on many factors including the particular diagnosis of hematologic malignancy and the stage of the patient’s disease at the time of transplant.
New answer by PaulODonnellMDPhD (Physician - Oncology - Hematology/Oncology (Verified))
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11 months ago
Allogeneic transplantation requires treatment of the patient also called conditioning therapy to accept the transplanted blood or marrow cells (the “graft”). Traditionally, conditioning therapy included high-dose chemotherapy and sometimes radiation intended to eliminate any cancer cells remaining after conventional therapy and to suppress the patient’s own immune system from rejecting the graft. However, the intensity of the conditioning therapy could be harmful to normal organs and especially normal bone marrow which was destroyed or ablated in the conditioning process. Normally, destruction of the normal bone marrow was not a problem since the donor’s stem cells in the graft would substitute and replace the patient’s marrow. Therefore, the donor’s stem cells would re- generate all the normal cells in the blood. However, if the grafted stem cells did not “take” also called graft rejection, the patient would be without any ability to make their own blood cells and could die as a result. Because of the toxicity of ablative conditioning to normal organs such as liver, lungs and kidneys, this type of transplant conditioning was usually reserved for younger, healthier patients usually under the age of 60 years. Over the past 15-20 years, an alternative type of conditioning called non-ablative conditioning has been developed which can prevent graft rejection and so can be used with older and less physically fit patients but is not so organ-toxic. In non-ablative conditioning, there is not the therapeutic advantage of the anti-cancer effect of high-dose chemo-radiation but it is now felt that the most important therapeutic effect of allogeneic transplantation is the anti-cancer effect of the donor’s immune response which is the same after either ablative or non-ablative conditioning.
New answer by PaulODonnellMDPhD (Physician - Oncology - Hematology/Oncology (Verified))
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11 months ago
An allogeneic blood or marrow transplant is one in which hematopoietic stem cells are transplanted from a related or unrelated, volunteer donor. “Allo” comes from the Greek allos for “other”. The main therapeutic effect of an allogeneic transplant comes from a potential immunological response of the donor’s immune cells, also called T-lymphocytes or T-cells, against the patient’s cancer cells. Patients who can benefit from an allogeneic hematopoietic cell transplant usually have cancers of the blood or lymph systems (leukemias, lymphomas or multiple myeloma) who are at high risk of relapsing after conventional treatments which include chemotherapy and/or radiotherapy.
New answer by PaulODonnellMDPhD (Physician - Oncology - Hematology/Oncology (Verified))
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11 months ago
What options does a patient have who needs a bone marrow transplant, but cannot find an exact match?
Normally, the strategy to find a donor for an allogeneic transplant is to perform tissue typing called HLA-typing among a patient’s siblings to find a match. If no match is found, then an attempt is made to find a match within the international registries which contain up to 10 million potential donors. If no matched sibling or unrelated donor is found, there are two options available. First is to search for an umbilical cord blood donor in the registries of cord blood banks. Cord blood units do not need to be completely matched. Second, is to consider a family donor who is at least half-matched which could be a sibling, a parent or a child of the patient.
New answer by PaulODonnellMDPhD (Physician - Oncology - Hematology/Oncology (Verified))
1
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11 months ago
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