At one time, bone marrow transplant or stem cell transplant for CML, was a standard treatment option. Currently, the majority of patients diagnosed in chronic phase of the disease will be able to control and manage their CML with daily medications called tyrosine kinase inhibitors. However, Stem Cell or Bone Marrow Transplant is still a viable option for some in our community. There are several criteria used to evaluate if transplant is right for someone living with CML. These include the phase of the patient's disease (chronic, accelerated or blast), patient's tolerance of the medication, and the disease's response to treatment.
A transplant is said to be the only treatment that has curative possibility. In fact, approximately 70% of CML transplant patients find their disease effectively cured. For those that relapse, recommencing TKI therapy (Imatinib, Dasatinib, Nilotinib and others) is often the preferred course of treatment. For some, a donor lymphocyte infusion can reverse the relapse.
An Allogeneic transplant (meaning a transplant from a donor - as opposed to an Autologous transplant meaning coming from one's self) has risks and is not an option for all patients. A transplant replaces the abnormal stem cells in the patient's bone marrow with healthy stem cells from a donor. The donor's cells also replace the patient's immune system, which can prevent the growth or proliferation of any remaining CML cells.
Several variables come into play. For example, persons over the age of 55 are generally not considered for transplant except in rare circumstances. Even then, outcomes can be very unpredictable. The general health of the patient is considered as well since the procedure can be quite rigorous. In older patients, the match must be of exceptional quality and the previous response to oral therapies is taken into consideration.
The National Cancer Institute prepared a slide presentation covering many of the important aspects of Stem Cell Transplants and it is available for you to review. We recommend viewing this information before discussing transplant options with your CML specialist, so that you can be prepared with questions and notes for your conversation.
The National Marrow Donor Program/Be The Match® has a section on CML Transplant Outcomes. This section provides information that can guide you on how to approach your doctor, and the appropriate questions to ask. You can also find additional resources on the "Resources" tab on the navigation bar above.
Contemplating a transplant or want to talk with an actual marrow donor? Let us know. We have individuals that are happy to share their experiences and answer any questions you may have. Email us at email@example.com.