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Hello, good to discover this site! My friend was diagnosed with ALL, but after what looked as a rather successful treatment, the ALL turns out to orginate from CML. Currently, as a CML patient, he has to follow 6 months Chemo...  To reduce risks that ALL would come back, a bone marrow transplantation is advised. Does anybody has such experiences? We are a bit afraid of the complications that may be caused by this transplantation. Many thanks!

 

Hi, from what you say your friends initial disease with CML went undiagnosed? Or was he diagnosed with Ph+ ALL?  I assume he will now be treated with high dose chemotherapy to get rid of the ALL cells and return his disease to an earlier form- is that right?

No matter, it sounds quite a complex case and no doubt he will need a transplant if he is to survive. Where is he being treated?

Sandy

Indeed, diagnosed 2 months ago with ALL Philadelphia +. Treatment with lighter chemo and Glivec. Blasts decreased rapidly to 0.11% but then, some 3 weeks ago a high level (some 35% ) of Philadelphia+ was found. Immediately Glivec was changed for Sprycell and we do not know yet the results of that. Doctors  ( he is treated in a University Hospital in Switzerland) presume  now that this relapse is the result of the fact that he has been in a chronicle phase before the Acute phase and his decease is now CML in stead of ALL, but they can not confirm this for a 100% yet. Today we have been extensively informed about the SCT and all the risks and potential consequences, given also his age (74, although in very good shape). We tend towards waiting for the results of (heavier) chemo next week, together with the Sprycell, and take it from there.

Have you known similar cases before?

Thank you sincerely

Laura

 

Blast phase CML is very similar to the way Acute Leukaemia's behave. It is possible for Chronic phase CML to 'miss' the middle stage (accelerated phase) and develop into Blastic/acute phase disease. I understand that dasatinib (Sprycel) is more effective in treating plastic phase disease compared to some of the other TKIs... although I am not sure about the data on how many see their disease respond over the long term . SCT is still an option even though your friend is older. If he is fit and generally in good health (apart from the CML) he may well be considered for some form of transplant if he can find a well matched donor. But dasatinib may well be effective for him.

Good luck,

Sandy

That's how I first presented over 20 years ago.