For Dr. Kamar Godder, there was no single child’s story of suffering from leukemia or other blood-related disorders that inspired her life’s work at Nicklaus Children’s Hospital, but rather an entire generation of boys and girls who were once very sick but getting better thanks to modern advances in blood and bone marrow transplantation.
“Hematology/oncology is changing all the time, and I felt that in my lifetime I could see a big change happening impacting children’s outcomes,” she says. “With bone marrow transplantation, one’s own impact is even more tangible and visible. Perhaps because you treat the sickest patients in oncology, they are the most interesting and attractive to me.”
Dr. Godder, medical director of the Blood and Bone Marrow Transplant Program at Nicklaus Children’s, trained in pediatrics in her native Israel at Hebrew University and Hadassah School of Medicine and completed a fellowship in pediatric hematology-oncology at Memorial Sloan-Kettering Cancer Center in New York.
Accredited, Experienced Care
The Blood and Marrow Transplant Program (BMT) at Nicklaus Children’s is South Florida’s first and most experienced care provider for children requiring bone marrow, cord or peripheral blood stem cell transplantation. Established in 1991, the program was originally accredited in 2003 by the Foundation for the Accreditation of Cellular Therapies (FACT) for all aspects of blood or marrow transplantation. The program continues to meet the stringent FACT standards, having achieved its most recent reaccreditation in 2017.
Nicklaus Children’s has also been designated a Blue Distinction Center for blood and marrow transplantation and is approved as a Center of Excellence by OptumHealth and Aetna in the category of pediatric blood and marrow transplantation.
The state-of-the-art Hematology-Oncology Unit within the hospital’s new Advanced Pediatric Care Pavilion features a seven-bed BMT Unit.
Once patients complete the inpatient portion of their recovery, they are able to return home to resume daily activities. Patients are then seen regularly at outpatient clinics to assess progress and support care management.
Reliable, Curative Treatments
There is much the public doesn’t know about Bone Marrow Transplantation, Dr. Godder believes, starting with what a reliable treatment it has become for so many suffering youngsters.
“This type of treatment originally was designed for patients with cancer,” she says. “It is curative for a certain group of cancer patients who do not respond to conventional therapy. Now that we have experience with it and we’ve learned how to decrease its toxicity, patients receiving bone marrow and blood transplants do really well. But just as important to know is that it’s actually curative, not only for cancer patients, not only for malignant disorders, but also for other blood disorders, and that’s why we are now focusing more and more on non-malignant disorders.”
The Gift of a New Immune System
One example of this evolution is in the treatment of sickle cell disease, which is prevalent in the African-American and Hispanic communities.
“It’s a devastating disease,” says Dr. Godder. “Those patients can be cured if they go for bone marrow transplant, since there’s no other cure for them today.”
She says that other, more rare diseases as some metabolic disorders that are fatal in children can also be cured with bone marrow transplant — if detected early. “The public knows that these treatments work for cancer, but they may not know how effective they can be for other conditions, as well.”
Today, 80% of pediatric leukemia patients will be cured with conventional treatments, but for those who are not, bone marrow transplants are no longer in the realm of the experimental. “We don’t take a patient who was just diagnosed with leukemia and take them straight to transplant; but if they fail the conventional therapy, then we do,” according to Dr. Godder.
“The process of the transplant starts with receiving medication that destroys or suppresses the person’s own bone marrow. Following that, the new blood or bone marrow is infused. The beauty of bone marrow transplantation is that the bone marrow is actually liquid, so the procedure of the transplant itself is just an infusion of those cells through the vein, “Dr. Godder says. “The stem cells we give are actually blood stem cells or hematopoietic stem cells. Moreover, patients do not have to continue with anti-rejection medication all of their lives. We don’t only transplant a system or an organ that is generating new blood cells, we also transplant a new immune system. That means that after some time, we can gradually take the patient off the immune suppressing (the rejection) medication, since the body is learning to tolerate the new immune system. Unlike a solid organ transplant where they need immune suppression for life, our patients eventually come off medication and can lead a normal life.”
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