do you have to be in total remission for allo STC

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hi there, my husband has Non-Hodgkins Lymphoma in his bone marrow - diagnosed in May last year and had 6 rounds of R-Bendamustine, which didn't work and then just finished 6 rounds of R-Chop, which also didn't work. So disappointing! So, the auto STC scheduled for August has been cancelled and our consultant has talked about a donor transplant - they have already tissue typed him to see if they can find a match.

My question is, will they go ahead with the allo transplant if he can't get into remission? How does this work? I think he has to have some more intensive chemo, but as his disease has so far proved resistant, I'm worried that it will prove resistant to the next lot of treatment too - and then the transplant can't go ahead.

Does anyone have any knowledge about this. I know our consultant will talk to us about this when we have more of a plan, but just wondering what other's experiences have been.

Thanks!

  • Hi  and welcome to our little corner.

    Yes it is preferable that he is in a window of remission as this give the best possible results…… but I went into both my Allo SCTs with active cancer as I could not be put into remission.

    My rare incurable type of NHL had become very aggressive (hit my community name to see my story) so we went for it as my options were running out….. my first Allo was June 2014 and that failed by Christmas that year.

    My second Allo SCT was Oct 2015 with remission achieved for the first time in over 17 years in Sep 2016…… there is always hope.

    Happy to talk more ((hugs))

    Mike (Thehighlander)

    It always seems impossible until its done - Nelson Mandela

    Community Champion Badge

  • Thank you so much for the reply. 

    It's very difficult to deal with the uncertainty and what to think. But these treatments are pretty strong and hopefully the next one will get him into remission. Is it unusual that they did your SCT with active cancer?

  • I would say it is unusual as is having 2 Allo SCTs but it was needs must in my case as I was n the clock ((hugs))

    Mike (Thehighlander)

    It always seems impossible until its done - Nelson Mandela

    Community Champion Badge

  • Hi 

    my understanding is that, while yes it is preferable to be in remission before an allo, the ideal is a ‘window’ of a few months as once they are able to reduce and remove anti-rejection medication, then the graft versus disease can begin, in other words, the new cells can recognise and start to kill the cancer.

    I hope it can work for your husband….

    hugs xxx

    Moomy

  • Hi Minnie50

    Moomy is correct, being in remission is the ideal position to be in pre SCT. however this should not prevent the transplant from going ahead. The clinicians may give treatment to your husband to put him in the best place possible for the SCT to be possible.

    My wife was on outpatient chemo for 6 months following her relapse for her AML and she was told that the transplant would go ahead as long as she was fit enough to cope with the treatment. Luckily they got her into remission and she is currently in UCLH London undergoing her conditioning for transplant next week.

    Hope all goes well for your husband.

    Fulhamboy (Nick)

  • Thank you Mommy, so when you say the ideal is a ‘window’ of a few months, is that while in remission? 

    And Fulhamboy (Nick), that's great about your wife, did they say the transplant would go ahead even if they couldn't get her into remission? 

    thanks!

  • That was meant to say Moomy!

    X

  • Hi Minnie50

    Yes, the transplant was scheduled with or without remission, but thankfully she is. Its just a little more difficult for the clinicians if not and more attention to possible risks and grafting issues. If there are no cancer cells present then the doner cells haven't got to work quite as hard to go and trace the bad cells and eradicate them.

    Nick

  • Ah ok, our consultant had said that my husband needs to be in remission before the donor transplant, which feels difficult as he has failed two treatments so far. He has Non Hodgkins Lymphoma so maybe there is a difference there. They may have identified some good matches for him on the register already though, so we just really need to get over this hurdle first. 

  • Just be aware that the chemo used to gain remission can be tough to cope with sometimes.

    hugs xxx

    Moomy