ALL Leukemia Treatment - Phase 4 - destruction of the bone marrow?

ALL Leukemia Treatment - Phase 4 - destruction of the bone marrow?
My boyfriend's son just started phase 3 of treatment for ALL Leukemia which involves purposely suppressing his immune system. Phase 4, which we should be starting in about 60 days, will involve destroying his bone marrow so that new (hopefulyl healthy) marrow can grow back. I've been trying to find information about this process - what happens, side effects, etc. - but everything keeps coming back to bone marrow trasplants, which he doesn't need as long as he stays in remission.

Has anyone else been through this and/or know where I can find more information about it? All we've been told is that Phase 4 is going to be really bad.
We've been told all along that the doctors see no reason for him to have a bone marrow transplant. I've read that doctors will sometimes take the patient's bone marrow and use it later via IV to replace the destroyed marrow. But everything else I can find talks about donors and such.

There doesn't seem to be any info on the process of destroying the marrow and the side effects during this phase of treatment. That's what I'm interested in.

- inverse_mushroom_cloud
I believe he has to have a bone marrow / stem cell transplant. When they kill off the existing marrow, something has to be used to seed the new marrow. They can use the person's own stem cells (autologous transplant) or someone else's.

Did they tell you there would be no transplant?

Poster, if they take his own marrow and put it back in that's a transplant. Why the thumb down? That's just a fact.

- midnightmoon
Your bf needs to schedule a consultation apt with the docs and have them explain exactly what will happen. Write down all of your questions so that you dont forget anything, and either write down the answers or voice record the apt.

It actually does sound like a bone marrow transplant, but autologuos instead of allogenic. Allogenic is the term used when donor stem cells are used, autologous is the term used when they use their own stem cells are used. Some patients can use their own stem cells if the marrow is disease free at the time the cells are taken.

The process is the same as a transplant with a donor, except they wont be using a donor. The transplant should engraft sooner than with a donor, and risks of graft v host disease are almost nonexistent.

Auto transplants are common with all, and I think this is what they are doing because you say they are going to completly destroy his marrow. If they are destroying his marrow, it HAS to be replaced by something else because it is completely destroyed, it rarely comes back on its own.

If the previous treatment has shown good results and his status is remission, his marrow is disease free and can be used for his own transplant. They will harvest his cells - probably by aphersis - and they sort of "clean" them to make sure there are no leukemia cells in them, and then they are reinfused, they make their way to the bone, engraft, and start growing marrow again.

IF this is what they are doing, they will give him high dose chemo and radiation called total body irradiation to destroy his marrow. He will be left with no immune system until the new cells engraft so risk of infection is high.

If is a VERY harsh process, even when using your own cells, and it comes with a long recovery period.

Your bf needs to clarify if this is what is going to happen or not. If it is, the risk of infection along with the risks of relapse need to be discussed and considered. My transplant was originally going to be auto as well, but I am aml, not all and I was in my second remission. Since I was in my second remission, chances of an eventual relapse with an auto transplant was high, and because of a complication specific to my case they werent sure if auto was appropriate, so I ended up using a donor.

treatment of ALL depends on its subtype -commonly L2 and B cells type in adults. Bone marrow ablation needs to be followed by fresh blood and/or bone marrow transplant at appropriate time.

It is intensive and he has to be kept away from all infections; so he is likely to be kept in hospital.

get more info from the Sloan Kettering site below and request information if u are in US or even call them if you like.

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