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Tuesday, February 25, 2014

Myeloablative vs Non-myeloablative Revisited

This debate seems to be a regular topic on the forums for HSCT.  And with good reason.  If you are contemplating HSCT it is a question you should be asking yourself.  I blogged about this very topic a while ago and even though I'm happy with what I wrote I have more to add.  A link to my previous post is below:-

Myeloablative vs Non-myeloablative

So what is new?  As the debate rages on I have four points I wish to make:-

  1. Since stage three trials for any HSCT are yet to be completed there is as yet no concrete proof of it's efficacy in any form.  However, the evidence is substantial and if you're like me you would believe that it is only a matter of time before we have proof.  My point is that if we still do not have concrete proof of the efficacy of HSCT in its entirety, how can we have proof of which protocol is better?
  2. Right now I believe that which HSCT protocol a patient wants is a matter of personal preference.  BUT, if you can't get the one you want you are better off with the other rather than nothing as long as it is genuine HSCT and not one of these half baked shonky treatments from some scungy snake oil salesman.
  3. This is a question that needs to be answered but not yet.  Once we have proof of the efficacy of HSCT (and we will) trials can be done to determine which is best.  It is also important to not that there are not simple two protocols for HSCT.  There are several protocols under both myeloablative and non-myeloablative treatments.  On top of that mix you can also throw in autologous (using your own stem cells) or allogenic (using donor stem cells).
  4. After the dust has settled I believe there will be room for both types of treatment.  The decision will come down to which disease, the nature of the disease, the patients medical history, current health, lifestyle and the patients own preference.  In short, each case will require its own slightly varied protocol to maximise the outcome for the patient.
At the end of the day the important thing is that you are happy with all aspects of your treatment from the treating doctors and their facility to the protocol they use.  There are no right or wrong answers, just what you are most comfortable with.

Stay well:)