Wayne -

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"Yes" to your thinking, IF you have a good match -

In a message dated 7/8/2010 2:42:30 P.M. Eastern Daylight Time, wayne@... writes:

Actually, that is the big lesson learned about the mini allow HSCT. You must NOT wait until you have run out of all options. Because when you have exausted all your other options, that means nothing is working and your cll is still active.Study after study have shown that the biggest factor affecting sucess of the transplant is to enter it while in a deep remission. This will allow time for the donor graft to take hold and kill off the remaining CLL cells.There are not a whole lot of CLL mini transplant patients, and the first batches, were those entering as "no other choice" with their disease not under control. Now that people are doing it sooner, the 2-year PFS rates are 60% ... But only half that, if you enter it with active disease.. The data looks like it is potentially curative, but it has not been a very long time for these patients, and not too many ... so no one really knows .. But at least its a lot better than the 0% chance without out ...I am unmutated and did FCR 3 years when my WBC got over 500, giant spleen, nodes, etc... I got a molecular remission, but it returned very aggressively after 3 years. Now I am repeating the FCR, and almost into another deep, but shorter remission.All the top and famous transplant doctors say I should do the transplant soon after I finish this FCR, because when the disease returns, it will be riskier and more difficult to get into a 3rd deep remission. Not to mention, other risks such as trasformations, even more agressive disease upon return, etc... Many of top and famous hematologists suggest if I get into a deep remission from this FCR, then wait and do the transplant on the 3rd remission.But since I'd be saving only about a year and must put myself through a much more aggressive chemo the 3rd time around (since its unlikely in a year there will be something better), and given how aggressive the disease came back the 2nd time, .. it seems more prudent to lean with the transplant doctors to do it sooner than later, since that will give the best chance for a cure, which is the goal.In anycase, the moral of the story is, if you have a potential donor match and want to use a transplant as potential curative approach, do your best to time the transplant when you are still sensitive to the drugs and can get into a deep remission. If you wait until nothing else is working, and your disease is active, BM > 10%, then its much less likely to work. In fact, my insurance company requirement for easy approval is to prove you are in deep remission.> > In a message dated 7/7/2010 12:27:11 P.M. Eastern Daylight Time, > > cllcanada@ writes:> > > > > > > > >> > Some look to HSCT, and it is been touted recently in the press as a CLL > > treatment option. However, it has a less than 50% chance of working and > > should only be considered for patients who have run out of options and that are > > at an age (usually under 60 years) and level of health to withstand having > > their immune systems totally wiped out and replaced with the immune system > > of a matched donor. > > > > But even in the best transplant situation CLL will return. It is not a > > cure...> > > > ~chris> > _http://cllcanada.ca_ (http://cllcanada.ca/)> >>

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-How do I unsubscribe?Jul 8, 2010 03:37:27 PM, wrote:

"Yes" to your thinking, IF you have a good match -

In a message dated 7/8/2010 2:42:30 P.M. Eastern Daylight Time, wayne@... writes:

Actually, that is the big lesson learned about the mini allow HSCT. You must NOT wait until you have run out of all options. Because when you have exausted all your other options, that means nothing is working and your cll is still active.Study after study have shown that the biggest factor affecting sucess of the transplant is to enter it while in a deep remission. This will allow time for the donor graft to take hold and kill off the remaining CLL cells.There are not a whole lot of CLL mini transplant patients, and the first batches, were those entering as "no other choice" with their disease not under control. Now that people are doing it sooner, the 2-year PFS rates are 60% ... But only half that, if you enter it with active disease.. The data looks like it is potentially curative, but it has not been a very long time for these patients, and not too many ... so no one really knows .. But at least its a lot better than the 0% chance without out ...I am unmutated and did FCR 3 years when my WBC got over 500, giant spleen, nodes, etc... I got a molecular remission, but it returned very aggressively after 3 years. Now I am repeating the FCR, and almost into another deep, but shorter remission.All the top and famous transplant doctors say I should do the transplant soon after I finish this FCR, because when the disease returns, it will be riskier and more difficult to get into a 3rd deep remission. Not to mention, other risks such as trasformations, even more agressive disease upon return, etc... Many of top and famous hematologists suggest if I get into a deep remission from this FCR, then wait and do the transplant on the 3rd remission.But since I'd be saving only about a year and must put myself through a much more aggressive chemo the 3rd time around (since its unlikely in a year there will be something better), and given how aggressive the disease came back the 2nd time, .. it seems more prudent to lean with the transplant doctors to do it sooner than later, since that will give the best chance for a cure, which is the goal.In anycase, the moral of the story is, if you have a potential donor match and want to use a transplant as potential curative approach, do your best to time the transplant when you are still sensitive to the drugs and can get into a deep remission. If you wait until nothing else is working, and your disease is active, BM > 10%, then its much less likely to work. In fact, my insurance company requirement for easy approval is to prove you are in deep remission.> > In a message dated 7/7/2010 12:27:11 P.M. Eastern Daylight Time, > > cllcanada@ writes:> > > > > > > > >> > Some look to HSCT, and it is been touted recently in the press as a CLL > > treatment option. However, it has a less than 50% chance of working and > > should only be considered for patients who have run out of options and that are > > at an age (usually under 60 years) and level of health to withstand having > > their immune systems totally wiped out and replaced with the immune system > > of a matched donor. > > > > But even in the best transplant situation CLL will return. It is not a > > cure...> > > > ~chris> > _http://cllcanada.ca_ (http://cllcanada.ca/)> >>