StemCell Therapy

Your doctor may recommend astem cell transplantationto treat your acute myeloid leukemia (AML). Stem cell transplantation isn't an option for everyone, especially because of the high, sometimes life-threatening risks associated with it.

Allogeneic stem cell transplantation is the most common type of stem cell transplantation used to treat AML.Studies show that allogeneic stem cell transplantation may benefit high-risk and intermediate-risk patients who are younger than 60 and have an HLA-matched sibling donor. Timing of an allogeneic stem cell transplantation is one of the most important factors influencing transplant outcomes, so it is very important to start a donor search as soon as possible in order to identify a suitably matched related or unrelated donor.

Autologous transplantation is sometimes used for patients who do not have an HLA-matched donor. Autologous transplants are used less frequently than allogeneic transplants for AML patients mainly because of the lack of a graft-versus-leukemia effect and the risk of returning some leukemia cells back to the patient.

Allogeneic stem cell transplantation involves transferring stem cells from a healthy person (the donor) to the patient. The procedure follows high-intensity chemotherapy, potent drugs that must be toxic enough to kill leukemic cells. Unfortunately, the drugs also take aim at normal stem cells in the bone marrow.

The main reasons for doing an allogeneic stem cell transplant are:

The decision to do a stem cell transplant depends on:

Allogeneic stem cell transplantation is used to treat certain AML patients. It is a curative treatment option for some AML patients in first remission.Allogeneic transplantation is associated with a higher rate of side effects and mortality than autologous transplant. However, it may be considered for patients with higher-risk AML, based on cytogenetic and molecular test results. The decision to perform an allogeneic transplant also depends on the age of the patient and the patients (or his or her familys) understanding of the potential benefits and risks.The upper age limit for transplantation varies by treatment center; many centers use age 60 or 65 years for allogeneic transplantation and 70 or 75years for reduced-intensity allogeneic transplantation.

Reduced-intensity allogeneic stem cell transplantation may be a treatment option for patients who are too old or who may have other medical conditions that prevent them from having a standard allogeneic stem cell transplant. The conditioning therapy used for a reduced-intensity transplant is of lower intensity than that for a standard stem cell transplant; it does not completely inactivate the patients immune system or treat the AML as intensively. Thus, if a suitable donor is available, patients up to age 75 may benefit from this form of treatment.

A serious risk of allogeneic and reduced-intensity allogenic stem cell transplantation is graft versus host disease (GVHD), which develops if the donor's immune cells attack your normal tissue. GVHD's effects can range from minor to life threatening.

Autologous stem cell transplantation involves "harvesting," or retrieving, noncancerous stem cells from the patients own body and freezing them. The cells are returned to the patients body after receiving intensive chemotherapy. The procedure is only appropriate for certain patients.

The question of which patients are likely to benefit from transplantation after their first complete remission is under study in clinical trials. The decision to do a stem cell transplant depends on whether the patients AML is favorable risk, intermediate risk or high risk. The doctor also considers:

Autologous transplantation is relatively safe for many patients, including older patients. For some AML patients who do not have an HLA-matched stem cell donor, therapy can be further intensified with very-high-dose chemotherapy followed by an autologous transplant.

Read the rest here:
Stem Cell Transplantation | Leukemia and Lymphoma Society

This entry was posted on September 26, 2018 at 11:43 am and is filed under Stem Cell Complications. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed. |