Where Does Transplant Fit Into AML Care?

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Topics include: Ask the Expert

Who is a transplant right for? What factors do doctors consider before treating an acute myeloid leukemia (AML) patient with a transplant? During this Ask the Expert segment, Dr. Daniel Pollyea, from the University of Colorado School of Medicine, explains the role of transplant in AML care, how it has changed in recent years, and which patients are good candidates for this type of treatment. Watch now to learn his AML expert knowledge.

This program is sponsored by AbbVie, Inc and Genentech, Inc. It is produced by Patient Power in partnership with The Leukemia & Lymphoma Society (LLS) and NeedyMeds. These organizations have no editorial control, and Patient Power is solely responsible for program content.

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Transcript

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.

Andrew Schorr:          

What about transplant? Some people, particularly younger people may have had a transplant, or you have a discussion with them about it. Where does that fit in now?

Dr. Pollyea:                 

Right. So, a transplant is still today the only way that for almost all patients with AML that their disease can be cured. There are some caveats there. There are some patients who can't be cured with chemotherapy alone. That's unusually or uncommon. Most patients will need a transplant to be cured.

The landscape of transplant has changed dramatically. So, we're not successfully doing lower intensity transplant regimens in patients up to their late 70s really. And so, age is less of a factor in my opinion in transplant patients. And we’re getting better and better at that. So, I believe that a transplant it still a reasonable consideration for a patient who may not be a candidate for intensive induction chemotherapy. So, it used to be that if you weren't a candidate for induction chemotherapy, then by extension, that would mean you couldn’t get a transplant. I don’t believe that's true anymore. 

I think if you're an older patient who can get into a remission with a less intensive regiment, which now we are able to do quite frequently with some of these new weapons in the arsenal, if you can get into a remission, then I think a transplant is not unreasonable, even if you're doctor said, look, you're not a candidate for intensive chemotherapy. So, the pool for transplants in getting bigger and deeper. We’re getting better and better at that. And so, I think that's a part of the conversation. 

Personally, that's a discussion that I begin in people who could be eligible for a transplant on day one. The day they're diagnosed. That’s part of the discussion that we start to have even that early on. Now, not everyone is a candidate. Some people are too old or too sick for a transplant. Some people hear about the risks of a transplant, and they say that's not for me. And that is a completely reasonable reaction or response to it. 

And so, in those cases, the strategy is more, let's see what we can do to deepen and prolong your remission so that you can live as long as possible, we may not be able to cure your disease without a transplant, but we can still do a much better job now, I believe, than even a few short years ago.

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 August 21, 2019