Q
: 1
07/13/2009 |
I am a 40 year old male who underwent an allogeneic bone marrow transplant for high risk leukemia about 7 years ago. I returned to work two years later, but needed to be accommodated in an area of low risk for contact with communicable diseases. My specialist continues to identify a need for limited contact. I was speaking with a nurse who said that nurses who had similar procedures had been placed in low risk areas as well, but that a study had been done indicating that there was no need for this type of restriction after a period of time post transplant. Are you aware of any such study and if so, could you identify who did it, or please provide your thoughts on the issue?
Generally, patients are able to resume their normal lives once they have been off any anti-rejection medications for at least 2 years, have no chronic GVHD, have reasonable immunoglobulin levels and T-cell numbers and have had all of their vaccine boosters completed.
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Q
: 2
06/20/2009 |
Is bone marrow transplantation considered experimental and investigational for Common Variable Immune Deficiency? Is it indicated for persistent parvovirus B19 infection due to impairment of antibody formation?
Allogeneic stem cell transplantation is the only potentially curative non-experimental therapy available for many primary immunodeficiencies. It should only be recommended for patients who have an isolated antibody deficiency against parvovirus and are experiencing severe and frequent infections that show no response to supportive care.
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Q
: 3
05/24/2009 |
I am 37 years old and I have sickle cell anemia. I have heard about bone marrow transplants being done for patients with sickle cell. Is this safe? What are the risks and complications?
Bone marrow transplantation is only indicated for certain sickle cell patients under the age of 16. In adults, transplantation could result in significant complications including graft rejection. This is not recommended as a possible treatment outside of a clinical trial.
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Q
: 4
04/20/2009 |
I am 58 years old and have Non-Hodgkin's large B-cell lymphoma that has transformed to aggressive marginal zone. It has been confined to my chest area. After 3 regimens of ECHAP, it is in remission according to very recent PET and CT scans. Unfortunately I had to have a lung removed due to the lymphoma a year ago. My oncologist believes this would be my best opportunity to receive an autologous stem cell transplant as my bone marrow biopsy has come back negative. I have had only two small doses of radiation due to the tumor closing my bronchial tube. In your opinion, would this procedure be advisable under the circumstances. My BMT doctor has told me it is risky. I have a 80-90% chance of recovering from the transplant alone. However, should the marginal zone come back, my options may be very limited. I was also advised that this could be a cure since it has turned aggressive and not indulent.
As long as your remaining lung is healthy, the survival of the transplant procedure should not be changed. Based on the information you are providing me, an autologous stem cell transplant seems to be very appropriate.
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Q
: 5
02/25/2009 |
Is there any indication for bone marrow transplantation in breast cancer patients with bones metastases?
No, as autologous stem cell transplantation has not been shown to be effective, even in patients without metastases.
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Q
: 6
01/06/2009 |
In the case of a poor mobilizer, for an autologous transplant, can stem cells collected from a marrow harvest be mixed with stem cells collected from the blood?
Yes, harvesting cells from the bone marrow is an alternative that could be used to collect additional stem cells, when previous peripheral blood mobilizations attempts were not successful.
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Q
: 7
12/29/2008 |
How long does it take for the transplant to "take?" How soon does the patient know if the transplant was effective? How many transplants can one person have?
In general, it takes about 10 to 14 days to have engraftment of white cells, followed by platelets and red cells. The success of the transplant can only be determined several years after the procedure (absence of relapse). Patients could potentially be treated with a second transplant and sometimes even with a third, depending on the age and overall health of the patient, the type of disease and the response of the malignancy to standard chemotherapy.
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Q
: 8
09/22/2008 |
My husband's doctor is thinking about using Rituxan to treat his chronic GVHD. I have read that it is rare, but possible to develope PML. He has had Leukemia 3 times and 3 types of Bone Marrow Transplants. Over the past almost 9 years, he has had 5 rounds of high dose chemo. He has also used cyclosporine, sirolimus, cell cept (previously & currently) and tacrolimus (currently) for long periods of time. He has also been on very high doses of prednisone. He had 4 IVs of imfliximab in 2/08. I was wondering if any of this would make for a bad combination with 4 doses of rituxan?
It is difficult to give you a straight answer, but the management of chronic GVHD is difficult and in many cases, there are no other viable alternatives.
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Q
: 9
07/17/2008 |
I am 41 years old, diagnosed with second recurrant non-Hodgkins lymphoma and myelodysplastic syndrome (MDS). Am currently awaiting an allogeneic stem cell transplant. Your Web site mentions that UMGCC performs about 100 stem cell transplant per year. How many of those are allogeneic, and how does that compare to other medical centers your size? Also, in your experience what's been the success rate of the procedure?
There are many factors that play a role in the outcome of an allogeneic stem cell transplant, including your overall health, previous therapy, type of MDS, response to therapy prior to the transplant and if you have a related or unrelated donor. We perform about 40 allogeneic transplants a year and our outcome is similar to other institutions with the same or larger number of patients.
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Q
: 10
03/12/2008 |
My uncle has Non-Hodgkins lymphoma cell type b. After his course of chemo for mets to his sinus and bones, they plan on doing a bone marrow transplant. My mom, his sister, plans on donating but hasn't had a type and match done yet. If she happens not to match, would a neice be a likey match for donation?
The ideal donor for a patient is a sibling donor that has at least 6 similar receptors (HLA typing) as the patient; three of these receptors are inherited from the father and three from the mother; thus it is extremely unlikely that a niece could be a good donor (at best 3 out of 6 match), as your father is from a different family.
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Q
: 11
02/21/2008 |
I would like to know if the donor can immediately go back to work after the bone marrow transplant?
If you are donating peripheral blood stem cells, the answer is yes, but I would suggest no heavy lifting for a couple of days. If you are donating bone marrow, I would recommend 2 to 3 days of rest before going back to work and I would recommend light work for an additional 3 to 5 days.
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Q
: 12
02/11/2008 |
My husband and I want to know exactly what is needed for a bone marrow match. How many proteins or antigens need to match up? How many are there altogether? Does the blood type A, B ,AB, O also have to match? What about the RH factor?
The best match is a donor with 8 alleles matched with the patient. The blood group or the RH factor do not have to match.
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Q
: 13
01/25/2008 |
I was wondering if it is possible for a nine-year-old boy to have a bone marrow transplant if the leukemia occurs after he has gone through chemothrapy twice? We don't have bone marrow transplant in Ethiopia. I am compeletly out of ideas about what to do next to save my little boy. Please give me advice.
Yes, it is possible to proceed with a transplant as long as there are no medical contraindications. You may want to approach some of your surrounding countries' embassies to determine if they are willing to help you.
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Q
: 14
12/21/2007 |
I am in the Dominican Republic. There is a coworker who has a son in need of a bone marrow transplant. He is a person with no resources and has kept his son alive with treatment and blood transfusions with the donations of coworkers and friends. We have done compatibility tests on both the young man's brother and sister, but unfortunately no luck. Where can we find him a bone marrow donor? Is there a list we can get him on? I greatly appreciate your time and effort.
If there is a transplant center in the Dominican Republic, they may be able to help you with an unrelated search through the National Marrow Donor Program or other international organizations.
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Q
: 15
12/11/2007 |
Can you please tell me about your center's experience in treating relapsed CLL patients? How many bone marrow or stem cell transplants in such patients do you do per year? Thank you.
Concerned mother of CLL patient.
Because of the many treatment options available, there are very few patients with CLL who receive a transplant. In general, patients are treated like other low-grade lymphomas, with an allogeneic transplant and reduced intensity protocols, that have fewer complications. We perform around 100 transplants a year, including 30 to 40 allogeneic patients.
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