The difference of opinion mainly comes from a relatively short history of Gleevec, some 7 1/2 years now. That lack of history makes many Oncs nervous about predicting very long term success of the CML drugs, even though they show great results so far. BMT has become a last resort for adults, but for children the issue of long term drug therapy vs. BMT is more of an emotional one. In the final analysis, you will need to make a decision based on far less information than you would like to have, since there is no easy answer.
The main positive issue for BMT is the possibility of a cure. That is a powerful motivator for some. But the negatives for BMT are a rather long list, including potentially not surviving the transplant, possible transplant failure (sometimes the transplant does not take, so no cure), the body fighting the transplanted cells and vice versa (painful and possibly debilitating graft vs host disease), potential sterility, increased risk of causing a secondary cancer, and so on. Please understand that I am not anti-transplant. It is just that there are good points and bad points to consider. If it were my child, I would not allow doctors to rush a decision. The window for BMT will not close quickly if no decision is made right now, so there is no reason to feel pressure to make a decision right away. The good news is that you have time to consider this carefully, since your son is responding well to Gleevec. Maybe you even have time to allow your son to make his own decision as he matures over the coming years. In reality, there is no right or wrong answer to this dilemma, but making an informed choice is important. Part of the choice depends on whether there is a "perfect match" marrow donor, defined as a 10 out of 10 human leukocyte antigen (HLA) match. The highest liklihood is from a sibling, whereby there is a 1 in 4 chance of a perfect match. Otherwise the odds get slim, although not impossible to match an unrelated donor somewhere in the world. So if he has siblings, I would pursue HLA typing for them to determine potential marrow donor status. This would be a good idea even as a back-up plan. Parents are not normally matches since they each have only 1/2 of the required genetic make-up. There is also the possibility of using cord blood stem cells. Here are some previous discussions on this site about transplant for children: http://groups.google.com/group/CMLHope/search?hl=en&group=CMLHope&q=child+transplant&qt_g=Search+this+group Here are some online resources to help understand the transplant process and issues: http://www.cancer.gov/cancertopics/factsheet/Therapy/bone-marrow-tran... http://www.bmtinfonet.org/bmt/bmt.book/chapter.7.html http://www.mdanderson.org/departments/bmt/display.cfm?id=D176629C-8E4... http://cpmcnet.columbia.edu/dept/medicine/bonemarrow/bmtinfo.html http://www.marrow.org/PATIENT/Undrstnd_Disease_Treat/Lrn_about_Diseas... http://asheducationbook.hematologylibrary.org/cgi/content/full/2006/1... http://www.cancerhelp.org.uk/help/default.asp?page=4852 http://cancerguide.org/bone_marrow.html http://www.patient.co.uk/showdoc/27000829/ http://www.cancerbackup.org.uk/Treatments/Stemcellbonemarrowtransplants/Generalinformation Sometimes it helps children to understand that they are not alone, and that other children share their same problem. Approximately 3800 children are diagnosed with all types of leukemia each year in the United States, and many more around the world. There are over 1000 children and teens with CML in the US, and thousands in other countries. You can find other children with CML and other forms of leukemia, read their stories, and talk with them at the following websites: http://www.newcmldrug.com/Children/Default.asp http://www.childrenwithcml.org.uk/forum.asp?slevel=0z81&parent_id=81 http://www.cancercompass.com/message-board/message/all,3049,0.htm http://www.kidscancernetwork.org/yourstory.html http://www.acor.org/leukemia/sites2.html http://cmlblog.spaces.live.com/default.aspx http://www.childrenshospital.org/az/Site2170/mainpageS2170P0.html https://www.teenagecancertrust.org/health-info/resources.php --~--~---------~--~----~------------~-------~--~----~ [CMLHope] A support group of http://cmlhope.com ------------------------------------------------- You received this message because you are subscribed to the Google Groups "CMLHope" group. To post to this group, send email to CMLHope@googlegroups.com To unsubscribe from this group, send email to [EMAIL PROTECTED] For more options, visit this group at http://groups.google.com/group/CMLHope -~----------~----~----~----~------~----~------~--~---
