Stem cell and bone marrow transplants for AML

Chemotherapy treatments reduce the production of blood cells by the bone marrow|. The rest periods between courses of chemotherapy allow your bone marrow to recover. However, there is a limit to how much chemotherapy you can have without it causing permanent damage to your bone marrow.

Chemotherapy, with or without radiotherapy|, is given, which destroys all the cells in your bone marrow. Soon afterwards, stem cells (the immature blood cells which develop into red cells, white cells and platelets) are given back into your blood through your central or PICC line|. These cells make their way into the bone marrow and start to make healthy blood cells.

You can have a transplant using your own stem cells (autologous transplant) or with stem cells donated by someone else (allogeneic transplant). Allogeneic transplants are more common than autologous transplants in AML. The donor can be a relative, usually a brother or sister whose bone marrow is a close match to your own.

It’s also possible to use an unrelated donor if tests have shown they are a good match with you. This type of transplant is called a VUD (Volunteer Unrelated Donor) transplant. The donor stem cells will also contain healthy immune cells, which attack any leukaemia cells that are left.

Some types of allogeneic transplants use less chemotherapy and radiotherapy and are known as reduced intensity or mini transplants.

After a transplant the new stem cells take a few weeks to settle in your bone marrow and produce the blood cells that you need. During this time you’ll have very low immunity. You’ll probably need to stay in hospital and be nursed in isolation. This is done to reduce your risk of infection until your white blood cell count has recovered.

Stem cell and bone marrow transplants carry some risk, and are generally carried out in major cancer treatment hospitals, so you may have to be treated at a hospital some distance from your home.

Bone marrow and stem cell transplants are not suitable for everyone with AML. If your doctor thinks that a transplant is necessary or possible for you, they will discuss it with you in detail.

We have more detailed information about allogeneic (donor) stem-cell transplants and high-dose treatment with stem-cell support|.