Indian hematologists report an extremely rare phenomenon: after a bone marrow transplant to a patient in complete remission of leukemia, healthy donor stem cells can in turn become leukemic. The transplant patient can then develop a new leukemia. With the proper bone marrow transplant cost in India you can have the best deal now.

Stem Cell Transplant Options

Hematopoietic stem cell transplantation is a procedure that offers a cure for patients with leukemia, including those with acute myeloid leukemia (AML), which originates in myeloid stem cells. These normally turn into red blood cells, white blood cells or platelets. In AML, there is overproduction of abnormal myeloid stem cells. Called blasts, these immature cells invade the bone marrow, which can no longer ensure the production of normal blood cells.

  • The main treatment for AML is chemotherapy. It aims to achieve complete remission, defined by the disappearance of all signs of the disease and the fact that abnormal blasts are no longer detectable in the bone marrow and blood. After complete remission, doctors can then consider administering a so-called “consolidation” treatment. It aims to prevent leukemic cells from reappearing and thus to maintain complete remission and prevent recurrence.

This post-remission treatment may consist of a hematopoietic stem cell transplant taken from a healthy person. The white blood cells, red blood cells and platelets of the patient are then replaced by the donor stem cells. It is allografre when the donor is a different person than the recipient.

Hematopoietic stem cell allograft

This allogeneic transplantation of hematopoietic stem cells requires finding a compatible donor, in this case a brother or a sister. In other cases, it is necessary to find a compatible unrelated donor, that is to say an individual whose cells have a genetic identity card as close as possible to that of the recipient.

  • It happens quite exceptionally that the hematopoietic stem cell transplant is responsible for a new leukemia in a patient who no longer had any signs of leukemia. This is referred to as acute post-allograft marrow leukemia developed from donor cells (donor cell leukemia).
  • According to the register of bone marrow transplants, 14 cases of acute leukemia have been identified after 10,000 hematopoietic stem cell transplants.
  • Molecular biologists and hematologists at the University Hospital of Angers report two cases of donor leukemia in the October 2018 issue of the European Journal of Haematology.

Leukemia from the donor’s cells

The first clinical observation concerns a patient in his twenties who had been successfully treated with chemotherapy for acute myeloid leukemia (AML) before receiving a hematopoietic stem cell transplant. The donor was his sister. Twenty-three years later, the patient developed a new type of leukemia, acute promyelocytic leukemia (APL). In this recipient, genetic analyzes showed that the leukemic cells came from his sister. The patient was successfully treated with chemotherapy and trans-retinoic acid. He has since been in complete remission. To this day, his sister has not developed leukemia, 33 years after donating bone marrow.