Stem Cell Transplantation
For your postremission therapy, your doctor may recommend high-dose chemotherapy followed by a stem cell transplantation. Although it's not the only type of stem cell transplantation, an allogeneic stem cell transplantation is the most common type used to treat acute lymphoblastic leukemia (ALL).
Allogeneic Stem Cell Transplantation
Allogeneic stem cell transplantation involves transferring stem cells from a healthy person (the donor) to the patient after high-intensity chemotherapy.
The main reasons for doing an allogeneic stem cell transplant are:
- to give strong doses of chemotherapy to kill ALL cells
- to start a fully-functioning supply of red cells, white cells and platelets with help from the transplanted donor stem cells
An allogeneic stem cell transplantation is a high-risk procedure and may not be a good choice for every ALL patient. Each patient is different, and a treatment that's good for you may be a poor choice for someone else.
Your doctor first looks at whether you have high-risk ALL or standard-risk ALL:
- If you have high-risk ALL and are in your first remission period, an allogeneic transplant may be an option if you have a matched related donor or a matched unrelated donor if a related donor isn't available.
- If you have standard-risk ALL and are in your first remission period, the choice between allogeneic transplant and continued chemotherapy is less clear. You and your doctor should discuss whether a standard allogeneic transplant or a reduced-intensity transplant is right for you.
The procedure may be a consideration for you if:
- you're not doing well with other treatments
- the expected benefits of stem cell transplant exceed the risks
- a matched donor is available
- you're at high risk of relapse
- you relapse after prior successful treatment
The decision to do a stem cell transplant also depends on:
- your overall health
- the likelihood that the disease will respond to the procedure's conditioning
- regimen of intensive chemotherapy
- the features of your leukemia
- your understanding of the transplant's benefits and risks
A serious risk of allogeneic 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.