Residual leukemia cells that cannot be detected by blood or marrow examination remain after a remission. These cells do not interfere with normal blood cell development, but they do have the potential to regrow and cause a relapse of leukemia. The goal of post-remission treatment is to eradicate these undetectable amounts of leukemia cells.
Post-remission therapy is based on individual factors such as the patient's age and his or her ability to tolerate intensive treatment. Usually, chemotherapy includes drugs not previously used during induction treatment. Cytogenetic test results and the availability of a stem cell donor may also influence the course of treatment.
Patients between the ages of approximately 1 and 50 years who are in remission and have a donor who matches their tissue type may be appropriate candidates for allogeneic bone marrow or stem cell transplantation. Allogeneic means the transplant comes from another person, usually a relative of the patient. The patient is first given high doses of chemotherapy to induce a remission. Then blood-forming cells from the donor are infused to restore blood production and immunity.
Whether a patient is a good candidate for a transplant depends on the features of the leukemia, probability of relapse, the age of the patient and his or her understanding of the potential benefits and risks. For example, a young adult with cytogenetic findings associated with a higher probability of relapse might be a good candidate for transplantation. Meanwhile, a child with a good prognosis would not be a candidate for transplantation unless the course of their disease was marked by a poor response to treatment or relapse.
Copyright © 2000 Oncology.com, Inc. All rights reserved.
