I Can't Decide Between Allogeneic or Autologous Transplant

Posted by chrissyade19 @chrissyade19, Jun 23 6:47pm

Hi, I’m 29 and I'm going through the process of being evaluated for a stem cell transplant but my medical history is somewhat complicated, which is making the transplant process even more complex. I have sickle cell anemia, which has been relatively stable for the majority of my life until I was 27, when I was diagnosed with two autoimmune disorders, RA and scleroderma. Both of the AIDs have made my sickle cell worse and my sickle cell has made the AIDs progress more quickly than they should have, which has negatively impacted my quality of life. My hematologist said I have two choices: I can either do a BMT, which would get rid of all 3 diseases, but it’s riskier, the mortality rate is higher and there are other factors to worry about like graft vs host disease. The other option is I do an autologous (they would use my own cells) stem cell transplant. It’s safer and the mortality rate is not as high, but it would only take care of my AIDs, meaning I would still have to live with sickle cell. I keep going back and forth between the two; on one hand, it would be nice to be free of all these diseases, but I’m terrified of all the risks and complications associated with it. I have so many other things going on in my body because of the scleroderma and it has caused so much damage to my body. Sometimes I have this fear I’ll die from the BMT. On the other hand, the autologous route is safer and I could live with the sickle cell. However, my fear is that if I relapse or the HSCT doesn’t work for my AIDs and I still have sickle cell, I’ll be back where I am right now. I don’t expect anyone to tell me what to do and my case is more complex since I don’t just have sickle cell, but I was hoping to hear from others who have done a bone marrow transplant if they think it’s worth the risk or not? What would you do if you were in my situation? Thanks.

Interested in more discussions like this? Go to the Bone Marrow Transplant (BMT) & CAR-T Cell Therapy Support Group.

@chrissyade19 - that sounds like a difficult decision. I’m facing a BMT as my only solution. There was a really good MPN conference in May 2026 that has some very informative presentations on BMT, GVHD and other topics. I’ll post the link next. BMT has gotten much safer- I’ll also post some information around that as well. You should review some of the chats on the BMT connection here too.

This is a great place for you to connect with others with experience and questions!

Betz

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I did not have your other co diagnosis. Why would a Bone Marrow Transplant be so dangerous from and unrelated donor? Just to have my BMT, I was diagnosed with MDS. This was 2 years after my breast cancer and genetic test with Brca2 and 2 other mutations. I choose the transplant. My MDS could become AML, leukemia.
It is good you shared your story. Others will post. You are young, so I would gather your questions to ask your medical team.
This is not an easy choice and your concern and fear are understood.

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