For some patients with AML, chemotherapy alone may bring long-term remission. Remission means that tests cannot find any leukemia cells and a patient is symptom-free. But for others, the disease is more aggressive and chemotherapy alone may not be enough. For these patients, getting a referral to a transplant doctor early in their disease may offer the best route to a cure or a long-term remission.
A bone marrow or cord blood transplant begins with chemotherapy, with or without radiation, to destroy the diseased cells and marrow. The transplant replaces diseased blood-forming cells with healthy ones.
There are two types of transplants: allogeneic and autologous. An allogeneic transplant uses healthy blood-forming cells from a family member, unrelated donor, or umbilical cord blood unit. An autologous transplant uses the patient’s own blood-forming cells, which are collected and stored.
Most transplants for AML are allogeneic. Autologous transplant isn’t usually used for AML because the risk of relapse (a return of the disease) is higher than with allogeneic transplant.
Understanding if transplant would help your AML
Be The Match is here to assist you and your family as you plan for transplant. Our patient services coordinators can answer your questions and provide support and education to help you navigate your transplant journey.
Whether a transplant is right for you depends on how likely the disease is to return. This is based on certain features of the leukemia, called risk factors, and your general health. A transplant doctor will weigh the risk of the leukemia coming back against getting a transplant that may cure the leukemia, but may also cause other problems. The doctor also considers whether your specific risk factors are a sign that chemotherapy is not likely to lead to a cure or long-term remission.
One way a doctor determines how likely the leukemia is to return is through cytogenetic testing. This means looking at the chromosomes in the leukemia cells. Chromosomes are thread-like strands of DNA that carry genetic information about your body. Certain changes in the chromosomes predict a lower risk of the disease returning. Others predict a higher risk.
If your disease has a high chance of returning and you are a good candidate for transplant, delaying a transplant may lower your likelihood of long-term remission or cure.
There are medical guidelines for when someone should be referred for a transplant consultation, whether or not you need a transplant at that time. Talking to a transplant doctor is especially recommended if your disease has any of the following features:
For AML in adults
- You had a disease such as myelodysplastic syndrome (MDS) that became AML
- Your AML was caused by another treatment, such as chemotherapy for another disease
- Your initial chemotherapy doesn’t lead to remission
- Your initial chemotherapy leads to a remission, but cytogenetic or molecular testing shows high-risk disease
- You relapse one or more times after chemotherapy
For AML in children
- Your child has high-risk cytogenetics such as monosomy 5 or 7
- Your child is under the age of two when diagnosed
- Your child’s AML was caused by another treatment, such as chemotherapy for another disease
- Your child’s initial chemotherapy doesn’t lead to remission
- Your child’s initial chemotherapy leads to remission, but cytogenetic or molecular testing shows high-risk disease
- Your child relapses one or more times after chemotherapy