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Leukemia Treatment Options
Blood Stem Cell Transplant
Blood stem cell transplants can treat AML by transplanting healthy blood-producing cells into the patient's bone marrow. The three sources of stem cells now being used for transplants are bone marrow, circulating blood (also known as peripheral blood), and umbilical cord blood.
In a blood stem cell transplant, the leukemia patient is first given a pre-transplant treatment of chemotherapy and/or radiation therapy to destroy the patient's leukemia cells and immune system. Blood stem cells are then put into the patient's blood to restore the patient's immune system and blood cell production.
Two Types of Stem Cell Transplants: Autologous and Allogeneic
There are two types of blood stem cell transplants that can be used to treat patients with acute myelogenous leukemia (AML):
· Autologous blood stem cell transplants use the patient's own blood stem cells.
· Allogeneic blood stem cell transplants use the blood stem cells of a donor.
For an autologous stem cell transplant, the patient's own blood stem cells are collected and frozen. After the patient has received high-dose chemotherapy and/or radiation therapy, the stem cells are put back into the patient. Autologous transplant patients avoid graft-versus-host disease, which can be a serious side effect of an allogeneic transplant.
Although some AML patients receive autologous transplants, allogeneic transplants are more common because relapse (return of the AML) is more common after autologous transplants. To do an allogeneic transplant, a donor is needed.
The donor can be either related or unrelated to the patient. Related donors are usually siblings. For a cancer patient thinking about a transplant, the first thing a doctor does is to tissue type the patient's family. If no matching family member is found, the patient's doctor can search the National Marrow Donor Program's Registry of more than 5 million potential marrow and blood stem cell donors for a match.
Whether a related or unrelated donor is used, the transplant procedure is the same: the blood stem cells are collected from a donor and given to the patient. Unlike in autologous transplants, however, the stem cells from allogeneic donors are rarely frozen; instead, they are usually infused into the patient within 24 hours of being collected.
Some allogeneic transplant recipients may get graft-versus-host disease. In graft-versus-host-disease the patient's new immune system -- created by the stem cells from the donor -- attacks the patient's body.
There are two types of graft-versus-host-disease: acute, when symptoms appear soon after transplant, and chronic, when symptoms develop slowly and may linger for months or years. Although graft-versus-host-disease can be very serious, doctors watch transplant recipients closely for signs of graft-versus-host-disease and can usually control graft-versus-host-disease with drugs.
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