Leukemia (AML)

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What Acute Myeloid Leukemia (AML) Patients Should Expect During A Bone Marrow Transplant

Dr. Caitlin Costello UC San Diego Health

What Is A Bone Marrow Transplant?

  • A bone marrow transplant replaces original bone marrow with healthy bone marrow through an IV drip
  • A patient will be in the hospital up to four weeks after the transplant for the new bone marrow to fully develop
  • The transplant will weaken a patient’s immune system, so physicians will provide antibiotics and blood transfusions to keep them safe

“As the patient if you’ve received your chemotherapy, and or your radiation, you’re ready for your transplant,” Dr. Caitlin Costello, a hematologist and medical oncologist at UC San Diego Health, tells the SurvivorNet family.

Acute myeloid leukemia (AML) is a type of cancer in the bone marrow. Once a person has received an AML diagnosis, and went through chemotherapy or radiation, the next step is the bone marrow transplant. This is critical in the treatment process, seeing as a person’s original bone marrow will be replaced by healthier bone marrow. While the procedure may sound frightening, Dr. Costello assures patients that it isn’t as suspenseful as it appears.

“It’s a procedure which we’ve spent the last many weeks and months building up to, and your nurse while you’re in the hospital will bring over basically a bag of blood, and it feels and looks like nothing more than a blood transfusion,” Dr. Costello says.

During the transplant, patients will be connected to an IV which will drip donor bone marrow into their system, and from there the bone marrow will enter into the body through the bloodstream. Patients will be in the hospital for two to four weeks after the transplant so they can be monitored while the bone marrow fully develops. There may be side effects from the transfusion such as significant fatigue, nausea, and a weakened immune system, but that’s what the medical team is there for.

“What we will be seeing happen to patients is on their blood tests that we check daily we see that their bone marrow is shutting down,” Dr. Costello says. “We see that their immune system is weakening, their bone marrow is no longer producing those immune system cells, their body is no longer producing the blood — the literal gas in their tank — and it’s during this time that we’re supporting you because we can keep your tank full, we can give you blood transfusions and platelet transfusions…as a means to keep you safe.”

In addition to blood and platelet transfusions, physicians will give patients protective antibiotics in order to keep them safe while their immune system is weak and the new bone marrow is growing.

Bone Marrow Biopsies For Acute Myeloid Leukemia (AML)

Symptoms of AML are caused by abnormal red and white blood cell counts, which are found in bone marrow. In order to examine these cells, physicians must perform a bone marrow biopsy which will extract liquid bone marrow and a small chip of bone from the back of the hip. Red and white blood cells are in charge of creating energy and fighting off infection in the body, so abnormal cells and low blood counts can lead to fatigue, shortness of breath, and infections.

“What we can do is actually make slides and look at cells underneath the microscope with our eyes to get a better sense of ‘are all the cells are there, are the cells normal, do they look abnormal’ and then we do additional testing from there to further characterize any abnormal cells that may be present,” Dr. Tara Lin, Director of the Acute Leukemia Program at the University of Kansas Medical Center, explains to SurvivorNet.

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Caitlin Costello, MD, is a board-certified hematologist and medical oncologist who specializes in treating a variety of blood cancers, including multiple myeloma, lymphoma, and leukemia. Read More

Treatment : Treatment Options

  • For people deemed healthy enough, induction therapy is the standard treatment for AML
  • The process involves a seven-day chemotherapy regiment, followed by several weeks of recovery
  • The goal with this high-dose of chemo is to induce remission

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  • A wave of new targeted therapies have been approved for the disease, and doctors hope these approvals will unlock new and improved treatment options for those living with AML

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