A Cure for CML: Allogeneic Stem Cell Transplant
The only way to potentially cure CML is with an allogeneic stem cell transplant. This CML treatment replaces the abnormal white blood cells stem cells from a matched donor, which results in the production of healthy blood cells.
You might wonder why your doctor didn't recommend an allogeneic stem cell transplant first. Prior to the development of the TKI drugs, such as imatinib, this procedure was recommended as the only known cure for CML There is a good reason for this. The TKI drugs have turned CML into a chronic disease, so allogeneic stem cell transplantation is now reserved for patients who aren't responsive to TKI drugs, or those in blast crisis.
Allogeneic stem cell transplantation also involves serious risks, including:
- Graft-versus-host disease. Also known as GVHD, this occurs when the new stem cells attack your body's native tissues.
- Other cancers
An allogeneic stem cell transplant is most likely to be effective if you're a good candidate. Your doctor might consider you a good candidate for a stem cell transplant if you:
- Are under age 60
- Are in generally good health
- Have a donor with a matching tissue type (often a sibling)
- Didn't have a hematologic remission with other treatments
During a stem cell transplant, you will first get high doses of chemotherapy drugs to kill the stem cells in your bone marrow. Then you will get new blood stem cells from a matched donor. These cells will form healthy blood cells to replace the abnormal cells produced by CML.
After the stem cell transplant, you might also get a donor lymphocyte infusion (DLI). For this treatment, you will get an infusion of white blood cells called lymphocytes. These cells will be taken from the original stem cell transplant donor. The lymphocytes will see your cancer cells as foreign and attack them.
When CML Progresses
Usually CML treatments do a good job of keeping the disease in the chronic phase. However, CML can progress to the accelerated and blastic phases. At these stages, CML becomes more difficult to treat. Your doctor might increase the dose of TKIs, change to a different TKI, add chemotherapy, or recommend an allogeneic stem cell transplant if you haven't already had one.
Another option is to try a CML treatment that is experimental. Researchers are always working on new CML therapies, which they test in CML clinical trials. By enrolling in a CML clinical trial, you can get access to cutting-edge treatments that are not yet available to the general public. To find out how you can participate in a CML clinical trial, talk to your doctor.