Bone marrow transplant?!

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It would be so very rare for a doctor to attempt a BMT without reaching remission first. Normally, remission is reached even before BMT conditioning (the week or so of heavy chemo and total body irradiation before transplant.)

In very rare cases, a patient simply cannot reach remission, and a transplant may be tried anyway as a last hope. I have not known anyone with ALL to do this, but two or three people with AML. It's not ideal, and it's very risky.

Work in pediatric oncology.

With ALL, You reach remission by killing all the "bad" cells in your body. Before a BMT(bone marrow transplant), You will get four to ten days of intense chemo, which will kill basically all the cells in your body, and then you will either get a day to rest or go straight into the transplant. It is better to be in remission before, but if they are not in remission yet, and things are looking bad, this may become a solution to make the patient "cured".
Hope this helps!

Experience