The Bone-Marrow-Transplant Revolution

[EastBayDad]

theatlantic.com/health/arch...

[Spark_Plug]

Couldn't get past the subscribe requirement. It maybe of general interest but of course, with all the -mab and -ibs combinations that could buy one years, BMT's and CAR-T treatment are pretty far down on the list. My opinion only.

[Skyshark]

CLL usually uses stem cell transplants, not marrow transplants. With novel drugs being highly effective the use of SCT has reduced to the younger patients with worst markers. SCT can use stem cells from cord blood.

nhsbt.nhs.uk/cord-blood-bank/

[Spark_Plug in reply to Skyshark]

Thanks, didn't know there was a difference, I've been editing one for the other as I read for 2+ years. I'll have to check that out.

[Skyshark in reply to Spark_Plug]

CLL mainly uses donor SCT, Allogenic SCT, AlloSCT. When a donor is used they are given a drug that increases the number of stem cells and makes more migrate into the blood. They are harvested from the blood in an apheresis machine, the rest of the blood is returned.

Bone marrow transplants tend to be used for Autologous transplants, AutoSCT, where the patients own marrow is used, usually because they can't produce enough stem cells in the blood.

Just 17 in UK BSBMTCT register in 2022, 15 Allo PB, 1 Allo CB and 1 Auto PB. For CLL the NHS prefers peripheral blood, rather than cord blood.

bsbmtct.org/activity/2022/

It's never been a "go to" therapy for CLL (but is used more for N.H.L). Partly because by the time they have failed all other therapies most are too old. FCR was available in 2009 and BR for older patients in 2011.

2021 14.

2020 13.

2019 14.

2018 19.

2017 27.

2016 31.

2015 20.

2014 21.

2013 44.

2012 74.

2011 85.

2010 54.

2009 110.

2008 54.

2007 43.

2006 65.

[thompsonellen2]

I just had a stem cell transplant consult since I am running out of options (and I'm 55 years old so not aging out any time soon). It's definitely the option you want to reserve for the end of the road. In the US CAR-T was just approved last month if you failed both BTKi and BCL2 treatment path meds. This is no picnic, but avoids host v graft risk which can be quite serious. I did actually freeze my son's cord blood 24 years ago, but in addition to being unlikely to be a match, there would only be enough stem cells for a very small person apparently.