Dear Michelle,
This is a real dilemma for you and must be so difficult. How old is your son, 11?
I understand that U Cords are a very successful source of donor cells because they contain very early progenitor cells (stem cells) and do not have the problems of antibodies causing problems with GVHD. If there is a cord with such a close match then that is a bonus. It is not considered that the cords match is needed to be so close. Usually they give 2 cords at the same time. This is to make sure that if one fails to engraft then the other will instead. So two separate cords can be given... even though they are different matches.
Cord stem cells are much more adaptable than the adult donor stem cells.
DLI's are used with the low dose chemo transplants such as I had... or they are used for getting rid of residual disease should you relapse after transplant.
If he is responding to dasatinib now he will respond to it later should it be that residual disease still exists after transplant.
In my case, I was resistant to imatinib before transplant, but regained my sensitivity after transplant and it kept my residual disease at low levels for 1 year post transplant. I then stopped IM and waited for RD to rise to 0.5% pcr then had 4 DLI's spaced over 12 months until the dose of mature lymphocytes was enough to knock out the cml cells.
This was because I opted to have a reduced intensity stem cell transplant within a study using IM for 12 months post transplant, then DLI. The study is at HH and Birmingham and a few other centres. I believe it is ongoing. However I think is only for adults and anyway might not use cord stem cells.
I assume they would recommend your son has the traditional high dose chemo transplant?
Maybe you could get a second opinion on whether he should go for transplant?
Let me know if I can advise further.
Sandy
