mini BMT

[JEZ]

My doctor mentioned a "mini" BMT but did not elaborate as it is too early for me to consider.... has anyone had experience with this or heard of its success... I am an older patient (59) with AA....

[Neil Cuadra]

There are a few way to classify transplants:

• autologous vs. syngeneic vs. allogeneic - are you your own donor, is the donor your identical twin, or is the donor someone else?
• related vs. unrelated - is the donor a family member?
• bone marrow vs. peripheral blood stem cells vs. umbilical cord stem cells - where did the donated cells come from?
• full conditioning vs. reduced intensity conditioning - do you get a full dose of chemotherapy or less than a full dose in preparation for the transplant?

You are asking about the last of these. It is called a "reduced intensity transplant" or a "non-myeloablative transplant" or simply a "mini-transplant". Unless you have a matched sibling your doctor is referring to an allogeneic unrelated reduced-intensity transplant. Although "BMT" implies a bone marrow transplant, we sometimes get lazy and say BMT when we mean "either a bone marrow or stem cell transplant".

With a mini-transplant, you get lower, less toxic doses of chemotherapy and/or radiation. Not all of your faulty bone marrow is eliminated but the donor's immune system (which becomes your immune system) can take on the job to fight the remaining disease cells.

Since the conditioning is less harsh, more people can tolerate it, making it possible to give transplants to a wider population of patients, particularly those of higher ages if they don't have other health issues that rule it out.

The pros and cons of mini-transplants compared with full transplants (or other treatments) are based on statistics about survival, transplant rejection, remission, relapse, and graft-versus-host disease (GVHD). Although the conventional wisdom may be that mini-transplants are less dangerous but carry a higher risk of graft rejection, all of these factors are being studied and doctors and patients are getting more and more information about the tradeoffs for various patient populations.

Much depends on the circumstances of each individual patient. Please let us know what your doctor says about the possibility of a mini-transplant for you.

[squirrellypoo]

Hi jez. My transplant in July was a mini transplant, but that was chosen partly because I had hardly any cells in my marrow to kill so they didn't need much! I found the transplant itself really easy - I didn't get sick once and had zero mouth sores and generally felt like myself, but my recovery seems to be on par with those who had full transplants with the same infection risks. You can read through my thread here for more about my experiences or feel free yo ask me questions!

[JEZ]

Thank you both for such good information. I actually have been reading your thread all along, Squirrellypoo, and did not realize it was a "mini." I am trying to anticipate my future options should I have to consider a BMT... Frankly, at my age, I was afraid of two things... death from the procedure itself or a very poor quality of life after it. It is encouraging to think that, should things get to that point, BMT may be a real option for me at least. Thank you for sharing the information! And I am so glad things are going well for you, Squirrellypoo!

JEZ

[kirsty]

hi just joined the site how old are you i have to children now with mds just would like to talk to someone who has had a bmt or waiting for a bmt would love to here from you how are you coping with all the stress kirsty

[JEZ]

Originally Posted by kirsty

hi just joined the site how old are you i have to children now with mds just would like to talk to someone who has had a bmt or waiting for a bmt would love to here from you how are you coping with all the stress kirsty

I am not sure who your question is for but I am 59.

JEZ

[Laura]

I am 25 and had a MUD transplant almost 6 months ago. There are many posts on here that highlight a few people's transplants. Feel free to read those. Do you have any specific questions?
Laura