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Cedars-Sinai Again Earns Top Stem Cell Transplant Ranking

Tue, 20 Jan 2026 08:00:00 -0800

For the sixth consecutive year, Cedars-Sinai patients who receive donor stem cell transplants for blood cancers like leukemia have significantly better survival outcomes than patients treated at most other institutions.

These outcomes place the medical center at the top of rankings recently released by the Center for International Bone and Marrow Transplant Research (CIBMTR). Cedars-Sinai is one of just seven adult transplant centers out of 176 in the U.S. where patient survival after transplant is significantly better than predicted.

“We have a carefully chosen approach to pretransplant conditioning and graft-versus-host disease prevention for our patients, which plays a vital role in our strong survival outcomes,” said John Chute, MD, director of the Division of Hematology and Cellular Therapy at Cedars-Sinai Cancer. “We also have a dedicated system for keeping patients in touch with their care team, which helps identify problems before they become serious.”

The greatest risk to stem cell transplant patients is during the first 100 days after transplant, said Ronald Paquette, MD, clinical director of the Stem Cell and Bone Marrow Transplant Program at Cedars-Sinai Cancer.

“We have modified our pretransplant regimens and post-transplant care to minimize toxicity to the patients and give them the best chance for a successful recovery,” Paquette said. “We also are careful to select stem cell donors who can provide the best-quality stem cell and immune cell recovery.”

An allogeneic transplant uses stem cells from a donor, rather than the patient’s own cells, and Paquette said the approaches to these transplants are specific to each institution.

Along with a uniform approach to pretransplant therapy, Chute and Paquette attributed Cedars-Sinai’s top ranking to the frequent use of younger half-matched donors—often a child or grandchild of the patient—to get patients to transplant more quickly.

“In addition to that, there is no replacement for the people who take care of the patients, from the transplant coordinators to the physicians, nurses and advanced practice providers,” Chute said. “The dedication of our team provides that crucial element that yields the best possible results for our patients.”

Chute and Paquette are currently exploring stem cell transplant for patients who would once have been thought “too old” for the procedure.

“Age 75 used to be the upper limit, but that was arbitrary,” Paquette said. “We have transplanted several patients over age 75 and all are doing well so far. We are hoping to learn more about the biology of transplant via these patients, to learn about the pluses and minuses of doing transplants in patients this age. We want to learn not only how to extend their survival but also how to maximize their quality of life.”

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Youngest Cedars-Sinai Stem Cell Donor Helps Doctors Treat Dad’s Leukemia

Tue, 16 Sep 2025 06:00:00 -0700

In July, Nick Mondek, MD, drove his healthy 9-year-old son Stephen to Cedars-Sinai on an important mission: To donate stem cells that might cure Mondek’s deadly blood cancer. Stephen’s donation would give Mondek a brand-new immune system—and make Stephen the hospital’s youngest-known stem cell donor.

“A donation from a child this young is very rare,” said Hoyoung Chung, DO, a critical care pediatrician at Cedars-Sinai Guerin Children’s. “Stephen was very brave, and our team made sure everything went perfectly so that this young boy could help his father.”

Mondek, an anesthesiologist who works in the Los Angeles area, was first diagnosed with acute myeloid leukemia, a cancer that affects the blood-forming cells in the bone marrow, in 2022. A stem cell transplant from his brother, a perfect genetic match, sent him into remission, but Mondek’s cancer returned in April of this year.

“We followed every clinical protocol but the disease still managed to come back, so we had a new problem on our hands,” said Ronald Paquette, MD, clinical director of the Stem Cell and Bone Marrow Transplant Program at Cedars-Sinai Cancer. “How could we treat his cancer a second time around and have a better chance that it doesn’t return?”

The only chance was another stem cell transplant from a new donor. A search among Mondek’s relatives and in the National Bone Marrow Registry failed to turn up a match, but Mondek recalled a close friend with lymphoma who received a transplant from his 18-year-old son.

“How young could you go with a donor?” he asked Paquette.

Paquette confirmed that Stephen, who turned 10 in August, was a possibility. Children receive half of their DNA from each of their parents, so Stephen would be a half-match to Mondek. Stephen would still have to be tested to be sure that his immune system would be compatible with his father’s, but Paquette said that if it was, a half-match might make the transplant more effective. A half-matched immune system might more easily recognize and kill the cancer cells in Mondek’s bone marrow, and transplants from younger donors tend to be most successful.

“The conversation with Stephen was pretty simple,” Mondek said. “I said, ‘Hey, Buddy, Dad's sick and they need someone to give me stem cells, and they want to know if you want to get tested to see if you can do it.’”

Stephen’s response: “When do we go?”

After testing showed that Stephen was a compatible donor, the care team at Cedars-Sinai Guerin Children’s evaluated him to make sure that he understood and was mature enough to agree to the procedure. Then, after several weeks of pre-donation prep, he was admitted to the pediatric intensive care unit for the donation. He had to be placed under general anesthesia so that doctors could insert a catheter into a vein in his neck. Then Stephen spent six hours in a hospital bed while his blood cycled through a centrifuge that separated out the stem cells.

Stephen’s mom, Danielle Boyer, his younger brother, John, and Mondek waited anxiously through the catheter placement.

“Being an anesthesiologist, I put people to sleep every day, so I reassured myself that everyone wakes up when they go to sleep under anesthesia,” Mondek said. “But during the whole process that I've gone through, those 60 minutes when Stephen was asleep were probably the toughest.”

But all was well. Stephen’s stem cells were collected and frozen, and the family was back home that night.

A week later it was Mondek’s turn. He spent six days at Cedars-Sinai receiving chemotherapy to suppress his immune system so that his body wouldn’t reject Stephen’s donor cells. Then he was ready for the transplant.

“Transplant day is always dramatic,” Paquette said. “The patient knows that they cannot survive without the stem cells, and the delivery of the stem cells into their body is like a rebirth. We call that day their stem cell birthday.”

Paquette said that it takes two to three weeks for the newly transplanted stem cells to begin to grow. For Mondek, this meant two more weeks in the hospital—and away from his family—to protect his newborn immune system. But on Aug. 16, Mondek was discharged from the hospital and made it to the final inning of Stephen’s Little League game.

“I felt good helping my dad,” Stephen said, “and it felt good to have him home.”

Paquette said that it could take a year or more to determine whether the new immune system Mondek received from Stephen can beat his leukemia. But he called Mondek “tough” and said that he and Mondek won’t accept anything less than a cure.

John Chute MD, director of the Division of Hematology and Cellular Therapy at Cedars-Sinai, said that the Mondek family’s experience is an example of the level of personalized, state-of-the-art care that Cedars-Sinai stem cell transplant patients receive.

“Our exceptional patient care is part of the reason that our stem cell transplantation program has enjoyed consecutive top 10 national rankings by the Center for International Blood and Marrow Transplant Registry (CIBMTR) for patient outcomes since 2021,” Chute said.

Mondek is optimistic about his particular outcome.

“Everything lined up for this,” Mondek said. “Dr. Paquette said the perfect donor for me would be someone who's young and healthy and a 50% match, and we found him. He was right here in front of us.”

Cedars-Sinai Again Earns Top Ranking for Blood and Marrow Transplants

Thu, 06 Feb 2025 07:00:00 -0800

For the fifth year in a row, Cedars-Sinai Cancer patients receiving donor stem cell transplants to treat blood and bone marrow cancer such as acute leukemia experienced better one-year survival rates than those treated at most other U.S. transplant centers.

The Blood and Marrow Transplant Program in the Division of Hematology and Cellular Therapy at Cedars-Sinai Cancer was one of just 12 among 172 adult transplant programs where patient survival one year after transplant exceeded expectations, according to 2024 rankings from the Center for International Blood and Marrow Transplant Research. Survival rate at Cedars-Sinai was 90%, which far exceeded the expected survival outcome of 68%-83%.

“We’ve made a variety of changes during the past several years that have had a dramatic impact on our patient outcomes,” said Ronald Paquette, MD, clinical director of the Stem Cell and Bone Marrow Transplant Program at Cedars-Sinai.

One important change, Paquette said, was routine use of the chemotherapy drug cyclophosphamide after each transplant. This helps prevent graft-versus-host disease, which causes the patient’s immune system to attack the recipient’s organs.

“That one change, which has since been validated through published research, led to an almost immediate 20% improvement in one-year survival rates,” Paquette said. “What we have done since then has been to fine-tune our processes.”

These refinements have included an adjustment to the therapies used to prepare a patient for transplantation, which is called a conditioning regimen. The therapies in the conditioning regimen kill the cancer cells in the patient’s body, make room in the patient’s bone marrow for the transplanted stem cells to grow, and help prevent the patient’s immune system from attacking the new cells.

“There are many possible combinations, and we initially tried to match the conditioning therapy to each patient’s specific disease scenario,” Paquette said. “What we have learned by carefully tracking patient outcomes is that it is more important to choose a regimen that pairs well with the posttransplant cyclophosphamide. Some combinations caused excessive toxicities to the kidneys and the lungs. We have narrowed our conditioning regimens to two that we have found to work best.”

Another improvement has come from a gradual increase in the number of transplants using half-matched donors—often a child or an extended family member—rather than a donor with a perfectly matched tissue type.

“For these half-matched transplants, the donors are most often children, nieces, nephews or even grandchildren,” Paquette said. “The median age for our transplant patients is 68 to 70, and our half-matched donors might be 30 or 40 years younger than the recipient. We’ve found that younger donors yield substantially better outcomes than older donors, and now 85% of our transplants are performed using these half-matched donors.”

John Chute, MD, director of the Division of Hematology and Cellular Therapy at Cedars-Sinai Cancer, attributes these improvements and the resulting run of high rankings to Paquette and the stem cell transplantation team.

“This ranking is a great tribute to Dr. Paquette, and to our amazing physicians, administrative staff, nurse practitioners, nurses, and other members of the care team,” Chute said. “There are many working parts to the transplant process and our stellar outcomes wouldn’t be possible without the expertise of a number of different people who provide the attentive care our patients need.”

The transplant team continues to investigate avenues for further refining their process, Paquette said. They are working to develop options for offering transplants to a broader range of patients, and to better understand the interaction between stem cells and host bone marrow and the effects of intestinal bacteria on the transplant process.

“Our current process is producing great outcomes, and through strategic steps we are continuing to refine it,” Paquette said. “Through all of these efforts, we hope to learn things that will help us further improve therapies in the future.”