When treating Acute Myeloid Leukemia, it’s important to recognize the distinction between remission and cure. “When their Acute Myeloid Leukemia is in remission and everything looks good, a lot of patients say, ‘Thanks. I'm done, right?'” says Dr. Richard Stone, director of the Adult Acute Leukemia Program at Dana-Farber Cancer Institute in Boston.
Instead, when a patient enters remission, it signals that they’re ready for the final phase of treatment. Post-treatment therapy offers the chance of a cure. It also reduces the risk of a recurrence, which can be caused by residual leukemia cells that may have remained in the blood after treatment.
Read MorePost-remission therapy can consist of one of three things:
- Additional cycles of chemotherapy
- Autologous stem cell transplant
- Allogeneic stem cell transplant
“The other big choice is allogeneic stem cell transplant, often called bone marrow transplant. And that's where we give you, the patient, chemotherapy to put your immune system to sleep,” says Dr. Stone, adding that sometimes radiation is included in the pre-transplant treatment plan for the same purpose. And then we give you cells from another individual.”
That donor could be:
- A sibling.
- An unrelated individual that’s a tissue match.
- A baby’s cord blood
- A half-matched person
“We give you those (donor) cells to replenish your bone-marrow compartment, where we expect those donated cells to kill off the residual undetected leukemic cells.” The result is called Graft vs. Leukemia effect, which means the donor cells have killed off any residual leukemia cells. ‘That's why stem-cell transplantation is a very effective anti-leukemic therapy,” Dr. Stone explains.
“Why don't we do it in everybody?” he asks. “Because it's pretty dangerous and we don't do unless we really think that's the only way we have to cure you.”
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