Bone Marrow Transplant for Myelofibrosis
What is a Bone Marrow Transplant?
For allogeneic hematopoietic cell transplantation (otherwise known as a bone marrow or stem cell transplant), hematopoietic (blood-forming) stem cells are transferred from a donor to the patient, essentially replacing defective stem cells with healthy ones. Before the stem cell infusion, the patient receives high doses of chemotherapy and/or radiation therapy to eradicate diseased bone marrow.
Allogeneic hematopoietic cell is currently the only treatment approach in MF that is potentially curative, with a substantial number of patients experiencing complete hematological, histological and molecular remission. However, such therapy is complicated by relatively high treatment-related mortality and morbidity.
Who is a candidate?
Of the MPNs, only those diagnosed with myelofibrosis would be considered for a transplant. Within that population, only a subset of people will be healthy enough to undergo a transplant. Patients need to carefully discuss whether or not they may be eligible for such a procedure, given the complexity and possibility for complications. Since age and the presence of other diseases elevates the risks associated with ASCT, the decision to pursue ASCT should take into consideration the patient’s risk tolerance and transplant-related prognostic score (a rough measure of likely success, based on factors specific to the patient and the transplant).
Preparing for a Transplant
Below are 6 presentations recorded at the 2018 BMTinfonet.org Celebrating a Second Chance at Life Survivorship Symposium with a multitude of information about how to prepare yourself both mentally and physically for an upcoming bone marrow transplant.
- Your Personal Survivorship Plan: What, Why and How: The presenter in this video, Dr. Linda Burns, will discuss bone marrow transplant survivorship care plans and why they are reccomended for patients undergoing a transplant.
- Strive to Thrive: How to Protect Your Health after an Autologous Transplant: Dr. Peter McSweeney presents an overview of an autologous transplant and discusses the side effects you can expect to see after the procedure.
- Strive to Thrive: How to Protect Your Health after an Allogeneic Transplant: In this video, Dr. Catherine Lee discusses the good and the bad of allogeneic transplants and how you can manage the late effects.
- Managing Emotional Challenges after Transplant: Transplant survivor, Dr. Melanie Stachelski, presents on common thoughts and emotions after your transplant and provides resources for support.
Paying for Transplant
As of 2016, Medicare now provides coverage for stem cell transplant for those patients who need one. The coverage is reserved for myelofibrosis patients who have a Dynamic Prognostic Scoring System ingermediate-2 or High primary or secondary MF score. They must also agree to participate in a prospective clinical study to evaluate their outcomes vs patients with the same score who are not undergoing a Stem Cell Transplant.
Read Stories of Others Who have Undergone Transplant:
- Ron Anderson
- Patient Story Marina Sampanes Peed San Diego 2015
- Stephen Lewis Griswold
Hematopoietic Cell Transplantation as Curative Therapy for Idiopathic Myelofibrosis, Advanced Polycythemia Vera, and Essential Thrombocythemia. H. Joachim Deeg et al. Biology of Blood and Marrow Transplantation, March 2007Volume 13, Issue 3, Pages 355–365 http://www.bbmt.org/article/S1083-8791(06)00754-3/abstract
Allogeneic hematopoietic cell transplantation versus drugs in myelofibrosis: the risk-benefit balancing act. A. Tefferi. Bone Marrow Transplantation (2010) 45, 419–421; doi:10.1038/bmt.2009.193 http://www.nature.com/bmt/journal/v45/n3/full/bmt2009193a.html#bib13