Bone Marrow Transplant  (BMT)

What is bone marrow transplant in children?

A bone marrow transplant (BMT), also called a stem cell transplant, is a treatment for some types of cancer and other diseases. During the treatment, your child’s bone marrow is replaced with healthy stem cells from your child or a donor. These stem cells grow into healthy bone marrow.

Bone marrow is a spongy substance found inside the bones. It makes all the body’s blood cells, including stem cells, which are young blood cells.

What conditions does a bone marrow transplant treat?

BMT is used to treat a wide range of diseases in children including:

• Some types of cancers, such as neuroblastoma, lymphoma, leukemia, rhabdomyosarcoma, brain tumors and kidney cancer
• Genetic conditions such as sickle cell disease (SCD), Diamond Blackfan anemia, thalassemia, Hurler syndrome and adrenoleukodystrophy
• Aplastic anemia
• Severe combined immunodeficiency (SCID)

Bone marrow transplants offer a cure for many serious diseases, but they are not right for everyone. Our experienced team at Arkansas Children’s can talk with you and your family about whether a bone marrow transplant might be right for your child.

What are the different types of bone marrow transplants?

There are three different types of bone marrow transplants. They are based on where the healthy stem cells come from.

• Autologous transplant. In this type of transplant, your child is their own donor. The healthy stem cells are taken from the center of a bone or the blood. They are filtered and stored before transplanting them back into your child’s blood.
• Allogenic transplant. This is a transplant from a donor who has similar genetic makeup to your child. The donor is often a sibling or parent. It can also be an unrelated matched donor from a bone marrow registry.
• Cord blood transplant. For these transplants, stem cells are taken from a baby’s umbilical cord after birth. Then they are stored until needed. Cord blood may come from your child’s own umbilical cord, or another child in your family, or matched from a cord blood registry.

How are bone marrow transplants done?

Bone marrow transplants are done in a few steps:

• To prepare the bone marrow for the new stem cells, your child will first get high doses of chemotherapy. This destroys the bone marrow so the new bone marrow has room to grow. The chemotherapy also suppresses the immune system, so the body is less likely to reject new stem cells from another donor.
• Your child will then rest for a few days before receiving the transplant.
• Finally, your child will receive the healthy stem cells through an intravenous (IV) into a large vein. During the infusion, your child may have some mild side effects, such as a fever, chills or shortness of breath.

What happens after a bone marrow transplant?

After the transplant, it usually takes a few weeks for the stem cells to start growing and making new blood cells. During this time, your child will stay in the hospital. This gives your child time to recover and allows the doctors to monitor their progress and watch for possible side effects.

It can take some time, 6 to 12 months or longer, for your child’s blood counts and immune system to return to normal. Your care team will closely monitor your child’s progress through these months.