Blood and Marrow Transplant Program
The Hyundai Cancer Institute at CHOC Children’s Blood and Marrow Transplantation (BMT) Program is made up of a team of highly trained oncology experts, including two dedicated nurse coordinators who assist patients and their families through the transplant process. The majority of children who may benefit from a transplant are those with leukemia, including acute lymphoblastic leukemia (ALL) and acute myelogenous leukemia (AML). Other conditions that may respond to transplantation include hematologic disorders such as immune deficiencies and aplastic anemia, Hodgkin’s and non-Hodgkin’s lymphoma, Ewing’s sarcoma and solid tumors including some brain tumors and neuroblastoma.
The Cancer Institute BMT Program is the only pediatric blood and marrow transplant program in Orange County and offers a full range of transplant procedures and services. In addition to performing all necessary tests and procedures prior to the transplant, we test immediate family members (siblings and parents) to see if they are a match for the patient. (For more information on testing extended family members, please see the questions and answers below about the blood and marrow transplant process.)
- Autologous bone marrow transplant
Transplant in which the patient receives his or her own bone marrow.
- Allogeneic bone marrow transplant
Bone marrow transplant with marrow from a person other than the patient. The marrow may come from a related donor (such as a sibling) or an unrelated donor.
- Peripheral blood stem cell transplant
In this process, the patient receives his or her own peripheral stem cells (autologous) or stem cells from a related donor (allogeneic).
- Umbilical cord blood transplant
In this procedure, blood is collected from the placenta after the umbilical cord is separated from a newborn baby. This blood contains large numbers of bone marrow stem cells and can be used as a source of donor cells from a sibling or unrelated donor for a bone marrow transplant.
Frequently Asked Questions About Blood or Marrow Transplant
- Bone marrow is sponge-like tissue that fills the hollow space inside bones. The bone marrow is responsible for the development and storage of most of the body's blood cells. This tissue contains the stem cells that produce red blood cells, white blood cells, and platelets. When a portion of a person’s bone marrow is collected for transplantation, it is called a “bone marrow harvest.”
- Peripheral blood is blood that circulates in the blood stream. Peripheral blood contains the same blood producing cells that are present in bone marrow. When a person’s peripheral stem cells are collected for transplantation, it is called a “peripheral blood stem cell collection” or “apheresis”.
- Umbilical cord blood is found in the umbilical cord of a newborn baby and is a rich source of stem cells that can be used in transplantation. Cord blood is collected from the umbilical cord of a newborn baby immediately after delivery. Once the cord blood has been collected, it is frozen and stored at a cord blood bank for future use. The stored cord blood is called a “cord blood unit (CBU).” Cord blood collection is a non-invasive procedure that is not harmful to either the mother or baby.
- replace diseased, non-functioning bone marrow with healthy functioning bone marrow for conditions such as leukemia, aplastic anemia and sickle cell anemia.
- replace the bone marrow and restore its normal function after high doses of chemotherapy or radiation are given to treat a malignancy. This process is often called "rescue" and used for diseases including lymphoma and neuroblastoma.
- replace bone marrow with genetically healthy functioning bone marrow to prevent further damage from a genetic disease process such as Hurler's syndrome and adrenoleukodystrophy disorder.
- some solid tumors (i.e., neuroblastoma, rhabdomyosarcoma, brain tumors)
- aplastic anemia
- immune deficiencies (severe combined immunodeficiency disorder, Wiskott-Aldrich syndrome)
- sickle cell disease
- Diamond-Blackfan anemia
- metabolic/storage diseases (i.e., Hurler's syndrome, adrenoleukodystrophy disorder)
- cancer of the kidneys
- special air filtered rooms
- diet restrictions
- isolation requirements
- restriction of visitors
- strict hygiene regimen
- frequent linen changes
- low platelets and low red blood cells
- fluid overload
- respiratory distress
- organ damage
- graft failure
- graft-versus-host disease
- are tested for infectious diseases such as AIDS and hepatitis.
- answer questions about their health history. This helps doctors find risks if the donors have an infectious or hereditary disease.
- are checked by doctors for signs of disease.
Understanding the Blood and Marrow Transplant Process
- Prior to the transplant, an extensive evaluation is completed by the Blood and Marrow Transplant (BMT) team. All other treatment options are discussed and evaluated for risk-versus-benefit.
- A complete medical history and physical examination are performed, including multiple tests to evaluate the child's blood and organ functions (i.e., heart, kidney, liver, lungs).
- A child will often come to the CHOC BMT center seven to 14 days prior to transplant for hydration, evaluation, placement of a catheter (also called a "central venous line") and other preparations. The central venous line is surgically placed in a vein in the chest area. Blood products and medications will be administered through the catheter.
- A suitable (tissue-typed and matched) donor must be available.
- nausea / vomiting
- chest pain
- spend several weeks in the hospital.
- be very susceptible to infection.
- experience excessive bleeding.
- have blood transfusions.
- be confined to an environment that will prevent them from being infected from sick people. take multiple antibiotics and other medications.
- be given medication to prevent graft-versus-host disease (if the transplant was allogeneic). The transplanted new cells (the graft) tend to attack the child's tissues (the host), even if the donor is a relative, such as a brother, sister, or parent.
- undergo continual laboratory testing.
- experience nausea, vomiting, diarrhea, mouth sores and extreme weakness.
- experience temporary emotional or psychological distress.
- extent of engraftment,
- presence of complications,
- the patient’s overall health, and
- suitable living arrangement must be available within a 50 mile radius from the hospital.
- Nursing Staff
- Respiratory Therapists
- Physical Therapists
- Lab Technicians
- Infectious Disease Specialists