When Is Stem Cell Transplant an Appropriate MPN Treatment?

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Topics include: Treatments

As part of our Ask the Expert series, Dr. Jason Gotlib from Stanford Cancer Institute discusses the risks and benefits of stem cell transplant.  He explains the types of transplant and how this treatment approach can be curative in some cases.

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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.        

Andrew Schorr:

So here's a question from Susan.  You've talked to us about transplant.  Susan wants to know, “Does stem cell transplant work, and who is it appropriate for?”

Dr. Gotlib:

So that's a great question.  And so the first thing I would say is that "transplant" is an umbrella term.  There are many nuances in terms of the types of transplants.  So there's a full allogeneic transplant.  There are so?called reduced intensity condition transplants where the conditioning regimen that we use to prepare the patient might be less intense. 

Generally speaking, though, a patient that has myelofibrosis, for example, and higher risk disease, for example intermediate 2 or higher—or high-risk disease on our scoring system, certainly might be a patient that would be eligible.  But the factors that go into that are their age, their general health and comorbid medical conditions, and of course whether there's a suitable donor. 

And I think issue of transplant is one of the hardest decisions that both the physician and patient have to make because we know that although it's curative there are real risks involved with a transplant, with up-front mortality, which in some cases can be 15 to 20 to 25 percent, and then certainly post-transplant complications that graft versus—graft-versus-host disease.  So we have to have a very long discussion with the patient about risk/benefits, whether this is something that the patient wants to pursue.  

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.

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Page last updated on October 30, 2015