The morning sun slices through venetian blinds at Hamilton Health Sciences’ Juravinski Hospital, casting tiger stripes across Adrian Wong’s hospital bed. The 43-year-old father of two watches as a nurse hangs a bag of stem cells—his sister’s cells—that will drip into his bloodstream over the next hour. For Wong, diagnosed with acute myeloid leukemia (AML) just five months earlier, this moment represents both an end and a beginning.
“I keep thinking about my kids,” Wong tells me, his voice steady despite the gravity of the moment. “Before this treatment, I wasn’t sure if I’d see my daughter graduate high school. Now I’m planning to embarrass her at her wedding someday.”
Wong’s cautious optimism reflects a significant shift in Canada’s approach to treating one of the most aggressive blood cancers. AML, which affects the bone marrow and blood, has historically carried a grim prognosis, with five-year survival rates hovering around 21 percent just a decade ago. Today, that figure approaches 40 percent for adults—an improvement driven largely by advancements in stem cell transplantation techniques and more personalized treatment protocols.
At treatment centers across Canada, medical teams are reporting unprecedented success with allogeneic stem cell transplants, where healthy stem cells from a donor replace a patient’s diseased cells after intensive chemotherapy. The procedure effectively gives patients an entirely new immune system—one that can recognize and attack any remaining cancer cells.
Dr. Ronan Foley, hematologist and Director of the Stem Cell Transplant Program at Juravinski Hospital, has witnessed this evolution firsthand. “When I started practicing twenty years ago, we reserved transplants for younger patients with few health complications. Today, we’re successfully treating patients in their seventies with comorbidities that would have excluded them in the past,” Dr. Foley explains as we tour the bone marrow transplant unit.
The advancements haven’t come easily. Canada’s healthcare system has invested significantly in specialized treatment centers, with major hospitals in Vancouver, Toronto, Montreal, and Halifax developing expertise in stem cell transplantation. The Canadian Blood and Marrow Transplant Group reports that approximately 600 Canadians receive stem cell transplants for AML annually—a number that has steadily increased by roughly 5 percent each year since 2015.
For Indigenous communities, particularly in northern territories, accessing these specialized treatments has historically presented additional challenges. Distance, cultural barriers, and systemic inequities have contributed to lower survival rates among Indigenous patients. Recognizing this disparity, several provinces have implemented programs that provide accommodation and financial support for patients traveling from remote areas.
Marianne Desjarlais, a health navigator with the First Nations Health Authority in British Columbia, works to bridge these gaps. “When someone from a remote community needs a transplant, they’re not just fighting cancer. They’re navigating an unfamiliar health system, often far from their support network and cultural practices,” Desjarlais says. “Our role is to ensure the healthcare system adapts to meet their needs, not the other way around.”
The procedural improvements are only part of the story. Equally important are the developments in post-transplant care. After receiving new stem cells, patients face the very real risk of graft-versus-host disease, where the donated cells attack the recipient’s body. Recent advances in immunosuppressive medications have significantly reduced this complication, allowing more patients to recover without life-threatening side effects.
When I visited Vancouver General Hospital’s leukemia ward last winter, nurse practitioner Susan Woo showed me a wall covered with photos of smiling transplant recipients—their “wall of hope,” as staff call it. “Ten years ago, this wall would have been much smaller,” Woo acknowledges. “Now we’re adding photos monthly.”
The Canadian Cancer Society’s most recent data supports this anecdotal evidence. Their reports show that while AML incidence rates have remained relatively stable, mortality rates have declined by approximately 1.5 percent annually since 2013—a trend researchers attribute to both improved transplantation techniques and better supportive care.
Financial considerations remain significant, however. A single stem cell transplant can cost the healthcare system upwards of $250,000, including pre-treatment, the procedure itself, and follow-up care. While provincial health plans cover these costs, the strain on the system is substantial, particularly as more patients become eligible for the procedure.
Dr. Eshetu Atenafu, biostatistician at Princess Margaret Cancer Centre in Toronto, has studied the economic impact of expanding transplant programs. “When we analyze cost-effectiveness, we have to consider not just immediate survival but quality of life and productive years regained,” Dr. Atenafu explains. “By these measures, stem cell transplantation has proven remarkably worthwhile, despite the high initial investment.”
For patients like Adrian Wong, these statistical improvements translate into precious time. Six months after his transplant, Wong is back at work part-time as an electrical engineer. He’s experiencing fatigue and must take immunosuppressants, but his most recent bone marrow biopsy showed no signs of leukemia.
“I track my recovery in small victories,” Wong shares during my follow-up visit to his home in Hamilton. “Last week, I coached my son’s soccer practice. Yesterday, I climbed a flight of stairs without stopping to rest. These moments would have been impossible without the transplant.”
Canadian researchers continue pushing boundaries in the field. At the University of British Columbia, scientists are exploring ways to reduce reliance on matched donors by modifying cells from partially matched family members. Meanwhile, teams at McGill University are investigating methods to identify which patients will benefit most from transplantation versus conventional chemotherapy, potentially sparing some the risks of the intensive procedure.
As Canada’s population ages, the incidence of AML is expected to increase, with approximately 1,400 new cases diagnosed annually. The advancements in stem cell transplantation offer hope that more of these patients will join the ranks of survivors like Wong—people who can look forward to embarrassing their children at future weddings, witnessing graduations, and experiencing countless ordinary moments that once seemed impossibly distant.
