Bone marrow transplant

Bone marrow is the spongy substance found inside large bones and is the ‘factory’ which produces the body’s blood cells.

The bone marrow makes three different types of blood cell – red, white and platelet. Stem cells are ‘mother’ blood cells that will develop into one of the three types of blood cell. Stem cells are found within the bone marrow, but can also be harvested from the peripheral blood. If bone marrow is used, the procedure is called a bone marrow transplant (BMT). If cells are harvested from the blood, the procedure is called a peripheral blood stem cell transplant (PBSCT)

Aim

The aim behind a bone marrow or stem cell transplant is to replace diseased bone marrow with a new healthy system so that the body can produce healthy blood cells once more.

They are used in many, sometimes highly individual circumstances so the information on this page is meant to be a general guide only. Parents can speak to their child’s Consultant about any aspects of these transplants and why their child may need one.

Why a transplant?

Transplants can be given as a treatment for certain types or stages of leukaemia– for example when they are in remission or have had a relapse. Stem cells from donor bone marrow, umbilical or peripheral blood are used. High does of chemotherapy are given to remove the child’s own diseased bone marrow and the new marrow is given as a transplant.  This is known as an allogenic transplant because the bone marrow is donated from another person.

Stem cells are also used as a supportive treatment when very high-doses of chemotherapy or radiotherapy have been needed to treat a particular type cancer. Stem cells from the child are collected and frozen before high dose therapy (chemotherapy or radiotherapy) is given. The high dose therapy can cause damage to the bone marrow (as well as the cancer cells) so the child’s own cells are then given (or re-infused) to ‘rescue’ the damaged bone marrow. This is a autologous transplant (as the stem cells are the child’s own) and is sometimes referred to as ‘high-dose therapy with stem-cell support’.

What happens?

The bone marrow or stem cells are given to the child via their central line and they will need special care after the procedure including antibiotics and - for some transplants - time in an isolation room. This is because the child will be very susceptible to infection whilst their body is without a healthy bone marrow system. Painkillers and some nutritional supportmay also be needed. Parents can ask their child’s Consultant about care needed after a transplant.

It is hoped that the bone marrow or stem cells will travel to the cavities within the bones and ‘graft’ and begin to produce healthy blood cells again.

Bone marrow and stem cell transplants can be complicated procedures. Parents can talk to their child’s Consultant about the risks and side-effects involved. Further information about these transplants is available by calling the Child Cancer Helpline on 0800 197 0068.