AML Patient and Expert Perspectives: What Is Transplant Like?

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Andrew Schorr:

So, Don, you went through a transplant, and I interviewed a transplant survivor years ago who did well afterwards, but he said, Andrew, it is not a walk in the park.  Now I know there have been a lot of refinements and you had it a number of years ago now, but what was the transplant experience like? 

Don Armstrong:

It wasn't a walk in the park. As a patient I think we hear what we want to hear, and I didn't really hear about a lot of the side effects that might occur from having a transplant because I was so focused on just surviving. I thought I had actually skated through the GvHD, the host?versus?graft disease resistance, until probably day 30 or so, and I started having presentation on my skin, and I started having issues with my throat, my eyes.  

So I had to go through all those additional struggles on top of fighting the initial treatment from the leukemia.  So it was tough, and it was something that, it was—it's difficult to be prepared for that because you've already been through all the chemo for the leukemia. I was grateful that the stem cells did what they were supposed to do, which was graft in my body, but the side effects were difficult.  They made it quite a challenge.  

Andrew Schorr:

And you continue to take some medicine related to anti?rejection?  

Don Armstrong:

No, sir.  I haven't taken anything now probably for, for probably six or seven years.  

Andrew Schorr:

Good.  Good.  Dr. Borate, just so we understand with a transplant.  So you're getting somebody else's cells to—you get the chemo to knock back the disease in your body, and then you're having somebody's healthy cells be infused to try to take offer the immune system.  My understanding is even your blood type can change.  I'm B?positive.  I get somebody who is O or something that becomes my blood type, right?   

Dr. Borate:

Yes.  

Andrew Schorr:

So it's a whole rebooting and a changeover, right?  

Dr. Borate:

Right.  I think the one thing I do want to clarify is you mentioned you get a lot of chemo to take care of the disease in your body, but most successful transplants are actually done when you're in remission, so when the patient is in remission.  Because the chemo that's given is really given to destroy your own existing bone marrow and immune system and to make a home and to make place for these new donor cells that will then come in and survive.  If you did not do that, then your immune system and your bone marrow would immediately reject any of those stem cells that were being given to the patient.  

If you still have disease in your body and a lot of disease, and then you get all this chemo to prepare you for a transplant, the risk of rejection or the disease coming back is actually quite high because when you—when you destroy your own bone marrow including bone marrow that has disease in it and then you infuse somebody else's stem cells, you have a period of about two to three weeks when you have no immunity. And the stem cells are trying to grow, but if the patient still has leukemia in their body or had disease when you started this process, those disease cells just grow out of control, and they kill all the donor stem cells, and then it's just not a good outcome.  

So we really want the patient to have as less disease, preferably no disease in their body when they get a stem cell transplant.  And this is not something that is intuitive to a lot of patients because it's seen as a treatment for AML, which it is, but you really want to give it when the disease is really under really good control.  

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.