SCT after Immunotherapy

My 16 year old son is currently undergoing Pembrolizumab immunotherapy for relapsed NK Tcell lymphoma. He previously had 25 fractions of RT and 6 cycles of SMILE chemotherapy. For the last 6 months discussions for an allo SCT have been on the table, then off and to be honest my head is done in with the constant will they won’t they.

We finally had a sit down with the Bone Marrow Transplant (BMT) team last Tuesday which in fact was a waste of time and they admitted that. They feel the risks of SCT are too great to risk move ahead because Ryan has already had immunotherpay he can’t now have a SCT according to them, Their advice was to stay as we are with Pembrolizumab until Ryan stops responding, then they will reassess the options.

Today his is consultant came to see us while we were having cycle 9 of Pembrolizumab. He is unhappy with what the BMT team said to us last week about SCT. The Haemotologists want an allo SCT, the BMT team say it is too risky. So we have two departments that need to fight it out and decide a plan without putting us in the middle of yes he is having a transplant or no he isn’t.

I cannot find any literature at all of SCT AFTER immunotherapy. The only literature is people having immunotherapy because they relapse AFTER SCT.

Has anyone here had immunotherapy and THEN a SCT, please?

Sarah

Hi Serah, it is always hard when two departments fight or see problems the other does not see. I would write to the head of both departments and if that does not work, write to the head of the hospital or if it is a trust, the board. This will make them have to answer why it is or is not to be done as the head of the hospital will want to know what is going on. I hope.
Anyway, that is what I would do, maybe you might get some answers.

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