How effective is allogeneic stem cell transplant for acute lymphoblastic leukaemia?

The transplant replaces unhealthy blood-forming marrow with stem cells from a donor. The new immune system may recognise and attack remaining leukaemia cells, while the conditioning treatment reduces existing marrow cells. Doctors assess response using blood tests, bone marrow examination and sometimes molecular tests. A deeper remission before transplant generally makes the treatment easier to evaluate, but it does not remove the possibility of relapse.

The process has significant risks, including infection, organ effects, graft-versus-host disease and slow recovery of blood counts. These risks are weighed against the risk posed by the leukaemia and other available treatments.

Your haematology team will review the leukaemia subtype, chromosome or gene findings, response to earlier treatment, donor availability and fitness for intensive therapy. Before admission, discuss fertility preservation, vaccinations, medicines, dental care and support at home. After infusion, follow instructions about hand hygiene, food safety, medicines and appointments. Regular monitoring checks blood counts, infections, graft function and signs that leukaemia is returning.

During recovery, contact the transplant team promptly for a fever, chills, breathlessness, new rash, persistent vomiting or diarrhoea, unusual bleeding, confusion, or a sudden reduction in urine. Do not wait for the next appointment: treatment can change quickly when immunity and blood counts are low.

Ask which response tests will be used, what the transplant is intended to achieve in your situation, how donor matching affects the plan, which complications are most relevant to you, and how relapse or graft-versus-host disease would be managed.