Stem cell transplantation is an option for the small proportion of myeloma patients between the ages of 30 and 65. The stem cells are precursor cells that are capable of developing into any type of blood cell. They are found in the bone marrow, and a small number circulate in the blood.
In an allogeneic bone marrow transplant, a patient receives a transplant of stem cells from another person. The donor and recipient's tissue types are matched as closely as possible so that the recipient's immune system will not attack the donated cells as foreign, a phenomenon called rejection. The patient is first given high doses of chemotherapy to destroy abnormal blood cells and induce a remission. Then the donated cells are infused to stimulate the regrowth of healthy marrow and blood cells.
High-dose chemotherapy, or high-dose chemotherapy and radiation followed by autologous stem cell infusion, is an appropriate option for patients up to the age of 65. Although this prolongs survival, it does not cure patients with myeloma.
In an autologous transplant, the stem cells are removed from a patient and treated to remove malignant cells. Patients then undergo high-dose chemotherapy or radiation and the stem cells are returned to the patient. However, it is unclear whether all the myeloma cells in the bone marrow can be destroyed.
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