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Pooja Khandelwal, MD, Assistant Professor, UC Department of Pediatrics and Member, Division of Bone Marrow Transplantation and Immune Deficiency, discusses bone marrow, gut health, and their work at Cincinnati Children’s Hospital Medical Center.

 

Podcast Points:

  • What conditions require a bone marrow transplant?
  • What is bone marrow?
  • How does the intestinal microbiome develop? 

As a principal investigator at Cincinnati Children’s Hospital, Dr. Khandelwal has a keen interest in acute graft versus host disease biology, the treatment of steroid refractory acute graft versus host disease, and management of refractory autoimmune cytopenias in the post-transplant setting. Her work is often focused on pediatric bone marrow transplantation and blood diseases.

Dr. Khandelwal discusses acute graft versus host disease that can occur after a transplant. She provides some data on the number of bone marrow transplants, stating that approximately 10,000 patients annually go through the procedure in the United States alone. She explains how it can be a curative modality for diseases that are either hard to treat or that have returned after remission.

Dr. Khandelwal provides some detailed information on bone marrow, explaining how it is a fascinating organ. As she states, bone marrow is a living organ in our bones that produces all the cells that make up our blood—white blood cells, red blood cells, and platelets. From carrying oxygen to the core of our immune system, to other crucial functions, our bone marrow is responsible for originating many important elements that are critical to our body’s health.

Dr. Khandelwal discusses matching immune systems, and the factors. She discusses proteins and the matches between recipients and donors. Further, Dr. Khandelwal explains the actual process of how bone marrow transplants work from a technical perspective.

She discusses how sophisticated the bone marrow is, and how it knows where it needs to go after transplanting it. The research doctor explains how chemotherapy is often used to eradicate a recipient’s current bone marrow to make room for the new, healthy bone marrow.

Continuing, Dr. Khandelwal explains the changes within intestinal microbiome over time, in transplantation. She discusses where disruption happens, and how they can restore the beneficial bacteria to patients’ bodies. Additionally, she provides information on how the intestinal microbiome is formed, and how human milk allows for the initial growth of an intestinal microbiome that can allow healthy systems to flourish. 

Wrapping up, Dr. Khandelwal discusses the future of transplants, and some of her perspectives on personalized medicine. 

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