Hi, Martha.
Here's some information about some of the questions you've asked.
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...they felt he should have a BMT before his RAEB became AML (for reasons that are unclear).
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It seems to be harder to treat AML that arises from MDS (called secondary AML or sAML) than it is to treat AML when it is the original or first disease (called de novo AML). The reasons for this difference are not clear, but doctors will usually push to get a patient to transplant before the conversion to AML if it looks like that is how the person's disease is progressing.
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So they are now searching for either a cord blood match or bone marrow from an unrelated donor. I was not there when this was explained but I assume that cord blood would be a PBSCT rather than a MUD BMT.
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You're right that a cord blood match would mean a stem cell transplant (PBSCT) but a matched unrelated donor might give either stem cells or bone marrow. The choice can depend on the donor's availability, the specifics of the treatment protocol, the patient's condition, and other factors. The jury is still out on which is better, but studies seem to indicate that stem cell transplants provide quicker recovery for the patient with fewer side effects but have a slightly higher risk of relapse. Bone marrow transplants have more treatment-related risks but are better able to eradicate disease.
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Also they have 2 cats, 2 dogs and a 2 year old grandchild that spends a lot of time with them. Will they have to be away from the home after my brother comes home and for how long?
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When I had my transplant in 1998, I was told that my dog couldn't be in my house for 100 days and that I should avoid contact with small children at all costs. I think these rules have been relaxed since then so that people who have had pets for a while do not have to be separated from them. But I think patients are advised not to bring new animals into the home because of the risk of introducing new challenges to a weakened immune system. Young children are breeding grounds for germs so common sense would say to limit contact with them during the initial recovery period, but it's not always possible in many families. Lots of hand washing, disinfectant wipes, and other safeguards should make it possible for your brother to enjoy time with his grandchild after his transplant.
Hope this helps. Let us know how Karl's donor search progresses.
Regards,
Ruth