AML Treatment with Bone Marrow Transplant: Survival Chances, Risks, and Further Details
A bone marrow transplant can be a lifesaving treatment for people with certain types of Acute Myeloid Leukemia (AML). This medical procedure involves the use of either the person's own stem cells or a donor's stem cells to help the body produce new blood cells and improve chances of survival.
Allogeneic Bone Marrow Transplants
Allogeneic transplants, which use stem cells from a donor, offer a potential cure, particularly for those with relapsed or refractory AML. While the 2-year overall survival (OS) and leukemia-free survival (LFS) can be around 45.5% for patients undergoing second salvage allo-HSCT after relapse, long-term survival beyond 5 years remains challenging in relapsed/refractory AML, with survival rates often less than 24% overall and below 15% for specific subtypes like t(8;21) AML after relapse. In children, the overall 5-year survival post-transplant can be higher (65-70%), though this relates to pediatric-specific studies combining various treatments.
Autologous Bone Marrow Transplants
Autologous transplants, which use cells from the person themselves, are associated with fewer side effects but are less commonly curative in AML as the patient's own marrow may harbor leukemic cells. As a result, autologous transplants generally have lower long-term survival success compared to allogeneic transplants. Exact survival rates are not specified in the provided data, but autologous transplants are typically considered in patients with favorable risk AML or when a suitable donor is unavailable.
Risks and Complications
A bone marrow transplant can cause serious side effects and potential risks, and a doctor will discuss these with a person when deciding on the best course of treatment. One of the most serious complications is graft-versus-host disease, which occurs when the person's body attacks the transplant. Allogenic transplants have a higher complication risk than autologous transplants due to the body's potential rejection of foreign cells.
The Transplant Process
Before receiving a transplant, a person with AML undergoes induction chemotherapy to put their cancer into remission. During the consolidation stage, a person's stem cells can be harvested, frozen, and saved for future use. After treatment (such as chemotherapy), healthy cells are transplanted back into the person.
In conclusion, bone marrow transplants offer hope for people with AML, but the risks and survival rates vary significantly. While allogeneic transplants offer a potential cure with long-term survival rates approximately 45-50% at 2 years for some patient subsets, survival beyond 5 years remains challenging in relapsed/refractory AML. Autologous transplant survival rates are generally lower and less well-defined, but allogeneic transplantation provides better long-term survival chances for AML patients eligible for such therapy. About half of people with AML who receive a transplant survive longer than 2 years.
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