Stem Cell Transplant for Myelofibrosis

Myelofibrosis is a rare kind of blood cancer that keeps your body from making the blood cells you need to be healthy. A stem cell transplant is the only treatment that can cure myelofibrosis. But it’s not right for everyone.

How It's Done

When you have what’s called an allogeneic stem cell transplant, you get special blood-forming stem cells from a donor. Once they're in your body, they can make your immune system stronger and help attack cancer cells.

A transplant involves several steps:

A donor match. First, you’ll need to find someone to give you some of their blood cells. Many times, this is a sibling or other family member, but you could also search a national donor registry. Your doctor also could use umbilical cord blood that was frozen at birth. Your blood and tissue will have to match that of your donor -- this is checked with a blood test or cheek swab.

Chemotherapy or radiation. Once you’re matched with a donor, you’ll go through at least one type of cancer treatment to get rid of as many cancer cells in your body as possible. It also weakens your immune system so it’s less likely to attack the new stem cells.

Stem cell transplant. Soon after you finish chemo or radiation, you’ll get your new stem cells. Your doctor will put them into your body through a long, thin tube that goes into a large vein in your neck or chest (called a central line). It can take about an hour, but you’ll likely need to stay in the hospital a while longer so your medical team can keep a close eye on you.

Frequent checkups. Your doctor will watch you closely for several weeks or months after the transplant in case you have any problems. You’ll check in often, and she'll do blood tests to check your progress.

Risks and Benefits

A stem cell transplant comes with chances of some serious side effects. Most can happen in the first 100 days after your transplant, when your immune system is still weak, but some won’t show up until months, or even years, later.

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Graft-versus-host disease. The new stem cells you get could start to attack your body’s healthy tissue.

Organ damage. Your spleen and liver play important roles in getting rid of old or problem red blood cells, so they can be affected by a transplant.

Cataracts. This is when the lenses of your eyes get cloudy and affect how well you can see.

Other types of cancer. Some people who have a stem cell transplant are more likely to get a different type of cancer later on.

Candidates for Stem Cell Transplants

Because of the risks involved, this procedure isn’t a good option for everyone with myelofibrosis. Your doctor will need to take into account:

Your symptoms. Depending on what they are and how they're affecting you, your doctor may try to manage your myelofibrosis with medicines rather than a transplant.

Your age. While older people are most likely to get myelofibrosis, being older means you might not respond well to a stem cell transplant. You’ll fare best if you’re 65 or younger.

Your health. You’ll need to be in very good shape to go through a transplant. If your doctor thinks you’re not healthy enough, she can still treat your symptoms and try to make you comfortable.

Future Treatments

A safer, less intense type of transplant is being studied. Called a nonmyeloablative or “mini” transplant, it doesn't call for as much chemotherapy and radiation.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on May 07, 2019

Sources

SOURCES:

Mayo Clinic: “Myelofibrosis,” “Bone Marrow Transplant.”

MPN Research Foundation: “Stem Cell Transplant for Myelofibrosis,” “Update on Promising MF Treatment, Momelotinib,” “Constellation Pharmaceuticals Provides Update on MANIFEST Clinical Trial of CPI-0610 in Myelofibrosis.”

Leukemia and Lymphoma Society: “Myelofibrosis Treatment.”

The ASCO Post: “Optimizing Allogeneic Stem Cell Transplantation in Myelofibrosis: A Conversation With Ayalew Tefferi, MD.”

Journal of Oncology Practice: “Allogeneic Hematopoietic Stem-Cell Transplantation for Myelofibrosis: A Practical Review.”

Cancer Treatment Centers of America: “Allogeneic stem cell transplant.”

American Cancer Society: “Stem Cell Transplant Side Effects.”

National Marrow Donor Registry/BetheMatch.org: “Chemotherapy or radiation before treatment,” “Learn about the risks and benefits.”

Haematologica: “Splenic pooling and loss of VCAM-1 causes an engraftment defect in patients with myelofibrosis after allogeneic hematopoietic stem cell transplantation.”

AJMC/American Journal of Managed Care: “Press release: Splenectomy Before Stem Cell Transplant May Help Certain Patients With MF.”

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