induction chemotherapy prior to bmt?

[rob k]

Was wondering if a patient's bmb was above 5%, does that person need induction chemotherapy to reduce blast counts prior to a bone marrow transplant? Has anyone done the induction chemotherapy for high risk mds after vidaza and revlimid have failed? How long does complete remission last? Has anyone used induction chemotherapy as a bridge to a bone marrow transplant? Any information would be greatly appreciated!

[Birgitta-A]

Hi Rob,
If you click Home in the meny of this page you can get info about MDS. In the chapter about treatment you will find SCT: http://www.marrowforums.org/mds.html#treatment
"Standard transplants begin with chemotherapy and radiation to destroy diseased cells".

Many patients receive SCT when Vidaza or Dacogen have failed - that is thought to be the best treatment because many of these patients get low counts and don't have positive results with other drugs. The problem is that most MDS patients are too old or have other diseases so they can't get a SCT.

A complete remission can last two months or longer - it is very different in different patients.

Your father had a very good response when he was treated with Vidaza and Revlimid! If he is healthy except for MDS he could perhaps get a SCT. Your doctor will tell you if he/she thinks it is possible.
Kind regards
Birgitta-A
73 yo, dx MDS Interm-1 2006. Initially supportive treament. Since 2010 Thalidomide + Prednisone with positive effect.

[DanL]

Rob,

Induction chemotherapy is still occasionally used for patients prior to stem cell transplant, but it does not seem to be as common as it may have been in the past. I think the primary reason is that it can really weaken the patient prior to transplant and make recovery more difficult.

there are several studies out there, but many of them come to the conclusion that since resistant MDS or AML are difficult to push into a full remission, it may not be worth the added risk. the decision of course depends on many variables including age and health of the patient, and how aggressive the disease seems to be at the time.