When Should AML Patients Consider a Splenectomy? | Transcript | Acute Myeloid Leukemia (AML) | Patient Power


When Should AML Patients Consider a Splenectomy?

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Andrew Schorr:          

Okay. As we mentioned, there are some people with my condition, myelofibrosis, who end up going to transplant developing AML.

And some of us will develop an enlarged spleen. So, we talked about chemo in getting ready for transplant. But should somebody have a splenectomy to take out that spleen beforehand? Where does that come into play? Either of you? Is that appropriate?

Dr. Nichols:                

There was some data at this conference, so I think it’s…

Dr. Levine:                  

…I think that it’s an evolving area. I think that 10 years ago, the answer would have been yes, in general, going into a bone marrow transplant with a giant organ full of blood cells that can be hard, if it’s even full of myelofibrosis cells, to get rid of. Patients often are wasting and not feeling well. And that big spleen is a big part of that. Their stomach gets compressed. So we used to do that a lot. I think we’re moving to an era where we’re doing it less and less. We have medicines now that can shrink the spleen in many patients. 

It’s still not outside of clinical trials. So we wouldn’t recommend that we would use medical treatments to shrink the spleen, unless you’re on a clinical trial. But we’re seeing some evidence that medicines like Jakafi or ruxolitinib, on a clinical trial, is part of the transplant regimen, may be useful, but it has to be done by someone who understands what they’re doing and is studying it and watching carefully. It’s not the same as taking ruxolitinib (Jakafi) outside as a treatment.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Page last updated on September 3, 2019