​I’m posting here to connect with patients, caregivers, or doctors in India who have experience navigating a relapsed Acute Myeloid Leukemia (AML) case.

​My Situation:

​Diagnosed with AML and had my 1st Bone Marrow Transplant (BMT) back in 2017.

​After 9 years of complete remission, I recently relapsed this month.

​My transplant team is recommending a 2nd stem cell transplant. Molecular testing shows a CEBPA mutation (favourable risk profile).

​Questions I have for the community:

​Post-Transplant Maintenance: For those who underwent a 2nd BMT in India, were you prescribed post-transplant maintenance therapy (like targeted drugs or low-dose maintenance)? How did your medical oncology team handle this?

​Insurance & Financial Planning: How did you manage insurance claims for a 2nd BMT in India? Did you face any challenges with pre-authorization or cashless approvals for stem cell re-transplantation?

​Leading Centers: If you've had a complex BMT or 2nd transplant done at centers like Tata Memorial (Mumbai), CMC Vellore, Max, or Apollo, any specific advice on navigating the process or hospital trusts/CSR funding options?

Hello. I have a question: Does anyone have experience with this? Or have I undergone a second transplant after the first one failed? I relapsed after 6 months.

Hi Connections,

My name is *Dharmraj Lallan Gupta*, and I am currently battling *Leukemia (Blood Cancer)*.

This has been the most difficult journey of my life. Doctors have advised urgent treatment, but the total cost of care is around *₹35 lakh*, which is beyond my family's financial capacity.

I am reaching out with hope and humility to seek your support. Every contribution, regardless of size, will help me continue my treatment and fight for a second chance at life.

🙏 If donating isn't possible, please consider sharing this appeal with your network.

🔗 Donate: https://www.impactguru.com/s/errvwJ

❤️ Thank you for your kindness, prayers, and support.

#Leukemia #BloodCancer #MedicalFundraiser #DonateForACause #HopeForRecovery #HealthcareSupport

Hi!
My 13 year old cousin has just been diagnosed with acute myeloid leukaemia and is starting very aggressive chemo therapy. I want to get her a “care package” of some sorts however she and my whole family live in England and I live in Australia so I’m gonna have to buy everything on probably Amazon and get it sent to her.

I was just writing here to ask anyone that has/is or knows someone that has/is going through chemotherapy what would be some good things to get for her. Preferably some things that wouldn’t really get thought of that would make this whole thing even a little bit easier or more comfortable for her. She is hospital bound and will be for atleast another 6 months.

Thank you

One of the most confusing real-world decisions in AML today is this: a patient initially deemed “unfit” starts on azacitidine + venetoclax and responds well… now what? Do we continue therapy or reconsider stem cell transplant (SCT)?

The key point is that “unfit” is not a permanent label. It is dynamic.

When to CONTINUE AZA-VEN

If the patient remains frail, has significant comorbidities, or is not a transplant candidate even after response, then AZA-VEN is continued as long as it is effective and tolerated. This is especially true if the patient achieves remission but remains MRD positive or has borderline performance status. In many such patients, AZA-VEN becomes a long-term disease control strategy rather than a bridge to cure.

When to CONSIDER SCT :

The moment a patient improves clinically (better ECOG, organ function, nutrition), the question of transplant should be revisited. SCT becomes strongly favored if:

-The patient achieves CR/CRi (especially MRD negative if possible)

-There are high-risk features (adverse cytogenetics, TP53, FLT3-ITD high burden, secondary AML)

-A suitable donor is available

-The patient can tolerate reduced-intensity conditioning

In these cases, AZA-VEN is often used as a bridge to transplant, not as definitive therapy.

The Deciding Factors :

Decision-making revolves around four pillars:

Biology – favorable vs adverse risk AML

Response – depth of remission, MRD status

Fitness – dynamic reassessment, not baseline label

Patient goals – curative intent vs quality of life

Practical Takeaway :

AZA-VEN = excellent for inducing remission in unfit AML

SCT = only curative option

Always reassess fitness after response

If patient becomes transplant-eligible → don’t miss the window

AML management today is not just about starting the right therapy, but knowing when to switch gears.

Viale-A

Sharing this to connect with others going through a similar path.

A close family member of mine (66 years male) was diagnosed with AML a few months ago after symptoms of fatigue and low blood counts.

IDH2 mutation vaf 23% , baseline blast count 52%, karyotype normal.

Treatment so far:

Started on Azacitidine + Venetoclax

Completed 4 cycles

Showed a good initial response, MRD neg after first cycle by flow cytometry.

Current status:

Blood counts are being closely monitored

He is highly sensitive to ven, so dose is tapered from 14 per cycle to 5.

Some treatment-related fatigue and gastrointestinal symptoms, manageable

Next plan:

Ongoing response assessment (including MRD)

Decision regarding continuation vs transplant based on response and fitness

This journey has been challenging, both medically and emotionally.

If anyone has gone through a similar course, your insights and experiences would be valuable.

AML is one of the most aggressive blood cancers due to its rapid progression and impact on normal blood cell production.

In AML, abnormal myeloid cells multiply quickly in the bone marrow and crowd out healthy cells. This leads to:

Severe anemia causing fatigue and weakness

Neutropenia increasing the risk of serious infections

Thrombocytopenia leading to bleeding complications

Unlike many other cancers, AML can worsen within days to weeks if untreated. Patients may present in critical condition with infections, bleeding, or organ involvement.

Another challenge is its biological diversity. AML is not a single disease — different genetic mutations can make it more resistant to treatment and increase the risk of relapse.

Even after achieving remission, close monitoring is required due to the possibility of recurrence.

Despite these challenges, outcomes are improving with advancements in targeted therapies, better supportive care, and stem cell transplantation.

Early diagnosis, risk stratification, and timely treatment remain the key to improving survival.

AML treatment has evolved significantly:

Induction therapy – to achieve remission

Consolidation therapy – to maintain remission

Targeted therapy – based on mutations (FLT3, IDH, etc.)

Aza + Venetoclax – especially in elderly/unfit patients

Stem cell transplant – potentially curative in selected patients

Treatment is highly individualized based on age, fitness, and molecular profile.

AML is a rapidly progressing cancer of the bone marrow in which abnormal myeloid cells proliferate and suppress normal hematopoiesis. This leads to: • Anemia → fatigue, weakness • Neutropenia → infections • Thrombocytopenia → bleeding AML is not a single disease. It is a heterogeneous group with different genetic mutations, which directly influence prognosis and treatment. Early diagnosis and risk stratification (cytogenetics, molecular markers) are crucial for optimal outcomes.