If I choose one treatment, does this influence any later choice, e.g. bone marrow transplant?
As mentioned above, The Hutch is recommending transplant early on in the disease. This also is the present thinking in chronic myelogenous leukemia, another myeloproliferative disorder. It is not known for sure but it seems highly possible that the choice you make about treatment may influence your system’s capacity to deal with subsequent choices. Prolonged chemotherapy damages organs and patients may be less able to weather the severe chemotherapy required prior to a bmt. Johns Hopkins Medical Center has a cut off of one year for prior chemotherapy for this reason. Some German researchers have claimed that CML patients treated with interferon first have not done so well with a bmt but other doctors do not accept their results. The Hutch followed by a warning about undergoing transplantion for CML for those on interferon more than one year. However, since some do well for a period of years with no treatment and some have seen improvement or reversal on interferon, this presents diffic
It is not known for sure but it seems highly possible that the choice you make about treatment may influence your system’s capacity to deal with subsequent choices. Prolonged chemotherapy damages organs and patients may be less able to weather the severe chemotherapy required prior to a bmt. Some German researchers have claimed that patients treated with interferon first have not done so well with a bmt but other doctors do not accept their results. Yet other doctors will withdraw interferon use about one year prior to a planned bmt. Watchful waiting may be a good choice for as long as possible if you are diagnosed early, your blood counts do not pose a risk of complications such as high platelets, etc. Also, new treatments are in the process of development each year so your choices may improve with time.
