A stem cell or bone marrow transplant aims to keep the leukaemia under control for as long as possible.
Stem cell or bone marrow transplant is a way of giving very high dose chemotherapy, sometimes with whole body radiotherapy. Only a handful of stem cell or bone marrow transplants are carried out each year for chronic lymphocytic leukaemia.
Why you might have it
Bone marrow or stem cell transplants are not commonly used for chronic lymphocytic leukaemia. The aim of transplant is to try to cure your chronic lymphocytic leukaemia, or control it for longer than is possible with other types of treatment. Your doctor is most likely to suggest a transplant if you are young and well enough to tolerate the intensive treatment.
You are most likely to have a transplant if your leukaemia has come back quite quickly after your initial treatment.
About stem cells and bone marrow
Bone marrow is a spongy material that fills the bones.
It contains early blood cells, called stem cells. These develop into the 3 different types of blood cell.
Matching donor cells
Everyone has their own set of proteins on the surface of their blood cells. The staff in the laboratory compare the surface of your blood cells and the donor blood cells. Your brother or sister are most likely to have similar proteins to you.
The staff check to see how similar the donor cells are to your own. This test is called HLA typing or tissue typing.
The laboratory staff look for proteins called HLA markers and histocompatibility antigens. They check for 10 HLA markers. The result of this test shows how good the HLA match is between you and the donor.
There is a 1 in 4 chance of a brother or sister being a perfect match.
You have a stem cell or bone marrow transplant after very high doses of chemotherapy and sometimes whole body radiotherapy. The chemotherapy and radiotherapy has a good chance of killing the cancer cells but also kills the stem cells in your bone marrow.
Before your high dose chemotherapy, your team collects a donor's stem cells or bone marrow.
After the treatment you have the cells into a vein through a drip. The cells find their way back to your bone marrow. Then you can make the blood cells you need again. It can take a few days or weeks for the stem cells to start making enough blood cells.
Possible side effects
The side effects of having a stem cell or bone marrow transplant are caused by high dose chemotherapy.
The main side effects include:
- increased risk of getting an infection
- low blood cell counts
- increased risk of bleeding
- a reaction called graft versus host disease, the donor cells can sometimes attack some of your own body cells
Research into mini transplants and timing
Researchers are looking into mini transplants or reduced intensity conditioning (RIC) for CLL. Mini transplants don't use quite such intensive treatment so your bone marrow is not destroyed. But the chemotherapy treatment used does suppress your immune system and allows donor blood cells to grow.