Acute myelogenous leukemia (AML) is a fast-growing blood cancer that develops in the bone marrow and interferes with the production of healthy white blood cells. The malignancy occurs after a single bone marrow cell undergoes an abnormal change that affects its DNA, which provides the cell with specific instructions on how to behave, including when to grow, reproduce and die. As a result, the damaged DNA incorrectly instructs the cell to multiply at a very rapid rate, and blood cell production veers out of control.
AML creates an accumulation of abnormal white blood cells (myeloblasts) that do not function properly. Eventually, the myeloblasts outnumber the healthy white blood cells circulating in the bloodstream. Because the body’s immune system needs a sufficient amount of healthy white blood cells to effectively fight off harmful invaders, such as viruses and bacteria, AML often causes frequent infections and flu-like symptoms.
The role of bone marrow transplantation in AML treatment
In most cases, AML treatment is a two-stage process. The first stage consists of remission induction therapy, which typically involves an intensive regimen of high-dose chemotherapy that requires hospitalization. The goal is to induce remission by destroying as many cancerous cells as possible. During this exhaustive process, however, most healthy bone marrow cells are destroyed as well.
If remission is successfully induced, the next stage of treatment consists of consolidation therapy. The goal is to replenish the body with healthy bone marrow cells and prevent an AML relapse. To accomplish this, some patients receive a bone marrow transplant (BMT). Two main types of BMT can be used to treat AML:
Allogeneic bone marrow transplantation
The most common type of BMT performed to treat AML, allogeneic transplantation involves the use of healthy blood-forming cells obtained from a compatible donor. After being infused into the patient’s bloodstream, the donated bone marrow cells then travel to the bone marrow and “jump-start” the production of healthy blood cells. Additionally, BMT may generate a further benefit, which is known as a graft-versus-leukemia (GVL) effect, which causes the body’s immune system to recognize any remaining leukemia cells as foreign so they will be attacked and destroyed.
Autologous bone marrow transplantation
An autologous bone marrow transplant is similar to an allogeneic bone marrow transplant; the main difference is that the bone marrow cells used for the procedure are harvested from the patient’s own body instead of a donor’s body. The collected cells are then frozen and stored until the patient completes remission induction therapy. Before being infused back into the patient’s bloodstream, the cells undergo a “purging” process to eliminate as many cancerous cells as possible and reduce the risk of reintroducing leukemia into the patient’s bloodstream.
Autologous bone marrow transplantation may be an option for a patient who does not have a compatible donor. Additionally, because the patient receives his or her own bone marrow cells, the procedure may be easier to tolerate and the risk of certain complications, such as graft-versus-host disease, is minimized. Even so, autologous bone marrow transplants are used less frequently than allogeneic transplants for AML patients, mainly due to the risk of returning some leukemia cells to the patient, and also because the procedure does not produce a GVL effect.
Benefit from a renowned and highly specialized bone marrow transplant program
Moffitt Cancer Center is an established leader in the field of bone marrow transplantation, and our Blood and Marrow Transplant and Cellular Immunotherapy Program is the largest and most active program of its kind in the southeastern United States. As a National Marrow Donor Program (NMDP) transplant and collection center, we are fully accredited by the Foundation for the Accreditation of Cellular Therapy (FACT). In a single location, our patients can benefit from comprehensive diagnostic, donor matching, bone marrow transplant and supportive care services.
If you would like to learn more about BMT or explore other treatment options for AML, you can rapidly connect with an experienced oncologist in the Malignant Hematology Program at Moffitt Cancer Center by calling 1-888-663-3488 or completing our new patient registration form online. With Moffitt, you can have access to cancer expertise within one day.