A bone marrow transplant can improve survival rates and reduce the risk of relapse for some people with acute myeloid leukemia (AML).

The above information comes from a 2021 article published in Frontiers in Immunology.

With an AML bone marrow transplant, either the person with cancer or a donor’s stem cells are harvested. After the person with cancer undergoes treatment (such as chemotherapy), the healthy cells are transplanted back into them.

This can improve the chances of survival for people with certain types of AML.

Many people with AML go into remission, but relapse is common. A bone marrow transplant can lower the risk of their cancer coming back.

Read on to learn about how bone marrow transplants for AML work, the different types, and the risks and benefits of a transplant.

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Chemotherapy is the main form of treatment used for AML. But it can cause serious side effects, including severe damage to a person’s bone marrow.

Doctors can use stem cell transplants to help a person recover from the harmful effects of treatment. Transplants may also allow a person to tolerate higher doses of chemotherapy.

A bone marrow transplant can also reduce a person’s risk for relapse. This is particularly important because AML has a high rate of relapse. Certain genetic mutations, such as FLT3-ITD mutations, can increase a person’s chance of their cancer returning.

After a person undergoes treatment, they get a bone marrow transplant.

The donor cells may either be their own cells or someone else’s. These healthy hematopoietic cells help the body produce new blood cells.

In addition to helping the body recover from intensive treatment, these cells can also reduce the chances of new cancer cells regrowing in the bone marrow.

Long-term survival rates after an AML bone marrow transplant vary depending on a person’s age, overall health, and disease progression.

According to a 2016 study, about half of people with AML who receive a transplant survive longer than 2 years. The study also found that people who had chemotherapy and a bone marrow transplant had higher survival rates than those who had chemotherapy alone.

In general, younger people tend to respond better to treatment. The Canadian Cancer Society reports that 65–70% of people under 60 years old will go into complete remission after induction therapy, which is the first phase of treatment. People over the age of 60 years typically have a lower response rate, with approximately 25–40% surviving for 3 years or longer.

Additionally, different types of transplants may result in different survival rates. Autologous transplants use cells from the person themselves, while allogenic transplants use cells from someone else.

Although allogenic transplants are more common, autologous transplants can be an option for people with low risk cancer.

A 2016 study of over 6,000 adults with AML found that people who received an autologous bone marrow transplant had a 5-year survival rate of 65%. For those who received an allogenic bone marrow transplant, it was 62%.

Although bone marrow transplants can increase a person’s survival rate, they can also cause serious complications. A doctor will discuss the potential risks and benefits of a transplant with a person when deciding on the best course of treatment.

A bone marrow transplant uses stem cells, which are basic cells that can grow into nearly any type of cell.

A bone marrow transplant, also called a hematopoietic stem cell transplant, transplants hematopoietic cells. These are a type of stem cell.

There are three types of stem cell transplants for AML: autologous, allogenic, and syngeneic.

Autologous bone marrow transplant

An autologous bone marrow transplant uses a person’s own stem cells. Doctors usually recommend this approach for people with low risk cancers.

This type of transplant is associated with fewer side effects and is less likely to cause life threatening complications.

Once a person has had enough chemotherapy to get rid of their cancer cells, they enter a stage called consolidation. This means they are tentatively in remission, but they need more chemotherapy to eliminate any residual leukemia.

During this stage, a doctor harvests the person’s stem cells to be frozen and saved for future use.

The stem cells can then be used later to help a person recover from the next stage of intensive chemotherapy.

Allogenic bone marrow transplant

An allogeneic bone marrow transplant uses stem cells from a donor.

Transplants using cells from close family members have the highest success rate, so these cells are used where possible. An unrelated donor can also give stem cells.

Allogenic transplants have a higher complication risk than autologous transplants. This is because the body may react negatively to cells it does not recognize.

Doctors only recommend this type of transplant for people with an intermediate to poor outlook.

Syngeneic bone marrow transplant

A syngeneic transplant uses stem cells from a person’s twin.

Like allogenic transplants, this is a good choice for people with moderate to high risk cancers. But the risk of complications with this type of transplants is lower because of the genetic similarities between the donor and recipient.

This type of transplant is only an option for people who have a twin, so it is relatively uncommon.

Before receiving a transplant, a person with AML will undergo treatment to send their cancer into remission. Doctors call this induction chemotherapy.

Once the cancer is in remission, doctors will either harvest a person’s stem cells and freeze them for later use, or they may harvest cells from a donor.

The person will then undergo more chemotherapy to get rid of any residual cancer cells. After that, they will receive the frozen stem cells.

These cells help new, normal cells regrow.

Learn more about how stem cell transplants work.

Although bone marrow transplants can improve outcomes for some people, there are risks associated with them. The most common risk is the body rejecting a donor transplant.

The risk of complications varies from person to person. An individual’s overall health may affect outcomes, since people in poor health may be more likely to have serious complications.

Some risks associated with bone marrow transplants include:

  • Graft-versus-host disease: This serious complication happens when the person’s body attacks the transplant.
  • Blood count issues: Following a transplant, a person may become anemic. They may also develop neutropenia, which is when they have too few white blood cells, increasing their risk for infection.
  • Organ damage: A person may develop sinusoidal obstruction syndrome. This means veins in the liver have blockages, causing organ damage.
  • Infection: A person may develop an infection after a transplant. Pneumonia is one of the most common.
  • Graft failure or rejection: This means that the transplant does not work. It causes an infection-like reaction that can make a person very ill.
  • Death: Rarely, the bone marrow transplant itself may be fatal, such as in the case of a severe infection.

Some people with AML may have a bone marrow transplant. This procedure involves harvesting stem cells, administering chemotherapy, and transplanting the healthy cells.

This can improve a person’s outlook and reduce their chances of relapse.

Despite these benefits, bone marrow transplants are serious procedures that carry risks. People should discuss treatment options and any concerns with a doctor.