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Should we consider bone marrow transplant for our child?

Q: My 10 years old son was detected with AML - M2 a couple of months back. He was given the first cycle of chemotherapy soon after. He was given UK AML 12 protocol. The medicines given were: lasix, evmset, methotrenate, amikacin, fortum, timentin, fluconazole, cytarbine, supacef, daunorubicin, etoposide, G CSF septran, digene, rantac and allopurinol. Later a bone marrow test was done that showed 60 % blast cell. Then a second cycle of chemotherapy UK AML 12 protocol was again given. Still the bone marrow test showed that blast cells were present. Now, the doctor has advised us to go for bone marrow transplantation. Where is this possible? Which is the best hospital to do the bone marrow transplantation? Also, what is success rate?

A:It is unfortunate that your son continues to have 40% blasts in the bone marrow after two cycles of chemotherapy. There are two options : 1. Trial of second line chemo with 'FLAG' regimen. Chance of getting complete remission (CR) is 30%. This may then be followed with HLA matched allo-transplant, if he gets a CR. 2. Bone marrow transplant from an HLA matched sibling Chance of cure is about 10%. Both the options have limitations, side effects and morbidity and mortality.


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