Making the Decision to Have a Stem Cell Transplant for CLL

Blood stem cells are immature cells that are the "starter" cells for new blood cells. When you have leukemia, a stem cell transplant can help your body make new healthy blood cells. It replaces the leukemia cells and stem cells that are killed during high-dose chemotherapy, allowing doctors to give you more intensive treatment.

You should know that stem cell transplants are somewhat controversial. Not all doctors think they work. They aren't used often for chronic lymphocytic leukemia (CLL). When they are used it is usually as part of a clinical trial. Your doctor may suggest one, though, in cases like these.

  • You do not respond to other treatment. Or it takes several courses of chemotherapy to bring about a remission.

  • You have a donor available whose tissue type matches yours.

  • You don't have a matched donor, but you have enough leukemia-free bone marrow cells to be collected for the transplant.

  • You're young enough to withstand the side effects.

  • You've discussed the risks and potential side effects with your doctor and feel you are willing to proceed.

Although still considered experimental, mini-transplants (also called nonmyeloablative transplants) are sometimes used for people with CLL. People receive a lower dose of chemotherapy and radiation, which doesn't completely destroy the cells in the bone marrow. But it is enough to suppress the immune system. Then people receive donor stem cells, which later develop an immune reaction to the cancer cells, killing them off.

Because this treatment uses lower doses of chemotherapy and radiation, it kills cancer cells with much less toxicity. Older people or those with other health problems can therefore better withstand this treatment.


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