When the field of cancer care was still in its infancy, a line was drawn down the middle: solid tumors like breast or lung cancer on one side, and blood cancers like leukemia and lymphoma on the other.
For decades, a diagnosis in the latter category was largely a death sentence. But fifty years ago, a high-risk medical gamble in a handful of labs across the United States forever changed the trajectory of oncology.
Thursday, May 28, as the global medical community marks World Blood Cancer Day, that history is colliding with next-generation cellular engineering at the edge of the Phoenix metro area.
“Blood cancers brought the foundation of modern oncology,” said Tibor Kovacsovics, M.D., a veteran hematologic oncologist and the Medical Director of Leukemia at City of Hope Phoenix in Goodyear. “The first active combined treatments in cancer history were developed here. From intensive chemotherapy, we moved to bone marrow transplants and we are entering now into genetically engineered cells.”
On May 1, City of Hope marked the 50th anniversary of its bone marrow transplant program. What began in 1976 as an experimental three-bed unit with two physicians has grown into a massive national network that has performed more than 20,000 transplants, making it one of the largest programs in the United States.
But according to Kovacsovics, the medical community almost gave up on the procedure before it ever truly started.
In the 1970s, bone marrow transplantation, replacing a patient's damaged, cancer-ridden blood-producing cells with healthy stem cells, was considered highly experimental and profoundly dangerous. Many major hospital boards across the country refused to fund it.
At City of Hope, it was a mix of leadership persistence and aggressive corporate philanthropy that ultimately kept the lights on. Early funding allowed physicians to prove the concept and City of Hope’s very first transplant recipient remained in remission for 35 years.
That single success sparked the hospital’s annual bone marrow transplant reunion, where thousands of survivors return to celebrate their “second birthdays,” the calendar date of their successful transplant.
“When patients go through a bone marrow transplant, it is a life-saving procedure,” Kovacsovics explained. “We define that milestone as a second birth. It signals that a grueling chapter of their treatment has finished.”
Bringing the lab to the West Valley
Kovacsovics, who relocated to Arizona three years ago from the Huntsman Cancer Institute in Utah, said the true value of modern medicine is worthless if a patient cannot access it.
According to the Nation Foundation for Cancer Reserch, blood cancer makes up approximately 10% of all new cancer diagnoses each year, stating that every three minutes, one person in the U.S. is diagnosed withblood cancer.
To address the rapid onset of diseases like acute myeloid leukemia, Kovacsovics helped pioneer an "Acute Leukemia Program" at the Goodyear location. Under this framework, any local physician or patient can call a dedicated line and bypass standard bureaucratic hoops, with the hospital committing to review the case and initiate specialized therapy within 24 hours.
He said that highly specialized leukemia treatments and clinical trials were usually consolidated into massive urban or coastal centers. City of Hope has spent the last several years expanding its footprint, establishing its clinical infrastructure across four states.
There are several loctions across the valley for specalized cancer treatment, but Kovacsovics said that City of Hope was the only one in the West Valley.
"We want to make sure that patients have access to care so they don't have to drive across the valley," Kovacsovics said. "Patients coming here in Phoenix can have access to the same top clinical trials as in California.”
The evolution of the transplant
While the core concept remains the same, the mechanics of how doctors handle bone marrow and stem cell transplants have changed drastically over Kovacsovics’s 20 years of clinical research.
Originally, harvesting required a highly invasive surgical procedure under general anesthesia to draw marrow directly from a donor's hip bones. Today, doctors rely primarily on blood stem cell transplants. Using a process called leukapheresis, donors are given medication to mobilize stem cells out of the bone marrow and into the bloodstream, where they can be collected seamlessly via an IV line, resembling a prolonged blood donation.
Finding a donor match has also evolved. While a patient only has a 25% chance of finding a perfect genetic match within their own siblings, international registries now hold tens of millions of voluntary donors.
Advancements in "haploidentical" transplants mean half-matched donors, like a parent, child, or sibling, can now safely be used, opening up options for patients who previously had none.
However, a hurdle remains.
"It is still much more difficult to find perfect matches for minority patients, including Black, Asian and Hispanic individuals," Kovacsovics said. "World Blood Cancer Day is a crucial reminder that we need a larger, more diverse pool of voluntary donors to close this gap."
The latest shift in care involves blending classic stem cell transplants with immunotherapy, specifically, Chimeric Antigen Receptor T-cell therapy.
Instead of just replacing the immune system, scientists are now rewriting its genetic code.
A classic bone marrow transplant stem cell replaces an immune system completely destroyed by intensive chemotherapy or radiation. While Chimeric Antigen Receptor T-cell therapy cells are extracted, genetically modified in a lab to target specific cancer proteins, multiplied and re-infused.
"With this combination, we are seeing success in patients where a regular transplant by itself was no longer efficient," said Kovacsovics. "We can start with CAR T-cell therapy for patients with highly aggressive diseases to force them into a response and then use the transplant to lock that response in place."
While already successful in treating acute lymphoblastic leukemia, lymphoma and multiple myeloma, clinical trials are actively underway to expand this engineering to hard-to-treat solid tumors like lung cancer and melanoma.
James Goldmeer Reporter | Goodyear & Litchfield Park
Meet James James Goldmeer joined Independent Newsmedia, Inc., USA, in July 2024, starting their career as a reporter in Goodyear and Litchfield Park.
Community: James grew up in the West Valley, calling Avondale home and going to school in Glendale and Peoria. Returning to the community after university, James plans to get involved in everything arts and culture, and civil rights.
Education: Northern Arizona University a bachelor's degree in Journalism, a certificate in Professional Communications, with a minor in English.
Random Fact: James spent half a year as an intern for the Arizona House of Representatives communication team, working with legislators to inform the public through press releases and social media.
Hobbies: James collects postcards and old books, reads memoirs and attends local jazz shows.
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