Transplants for More Kids, With Better Results

We work to make transplant an option for more young people and to improve cure rates. We continue to fine-tune the treatments to improve survival and reduce complications. New advances let us transplant patients who were not eligible in the past or who would be considered too high risk at other centers.

Some of these options are only offered in clinical trials including the following:

• Using a new, less toxic chemotherapy drug to get the body ready to accept stem cells. Lauri Burroughs leads the study.
• Using T-cell immunotherapy to put patients' cancer into remission so they can receive a transplant.
• Making transplant available to children who do not have a fully matched donor. This includes using stem cells from donors whose cell types are not a close match, such as half-matched or haploidentical donors. Drs. Burroughs and Kanwal Mallhi lead these studies.
• Using new ways to treat the donor stem cells in order to reduce the chance of graft-versus-host disease and the risk of relapse for children with leukemia. Dr. Marie Bleakley leads these studies.

Two Types of Transplants

There are two types of transplants: allogeneic and autologous.

Allogeneic transplants

A transplant using stem cells from another person is called allogeneic. The new cells replace cells that are abnormal or missing because of disease. Your child may need this type of transplant if they have a nonmalignant condition or a cancer that starts in their bone marrow, like leukemia.

The new stem cells may be from:

• A sibling or other family member. The transplant has a better chance of success if there is a close match between the cells of the donor and the child getting the transplant. Doctors look for a match of proteins on white blood cells, called human leukocyte antigens (HLAs). Siblings are more likely to be a close match.
• A volunteer who is not related but whose cells are a close match.
• Umbilical cord blood that has been frozen and stored.

Autologous transplants

In some cases, a child receives a transplant of their own stem cells, called autologous. Children get this type of transplant if they have healthy bone marrow but their cancer treatment is likely to destroy it.

Your child’s stem cells are removed before high-dose chemotherapy or radiation. Their cells are frozen and stored. After treatment is finished, doctors return the stem cells to your child's body through a vein. This type of transplant sometimes is called stem cell rescue.

Sources of Stem Cells

A transplant replaces the body's system for making blood cells, including cells needed for a healthy immune system. Stem cells for transplants may come from your child or a healthy donor. Your child receives the stem cells through a tube, also called as a catheter, into their vein. Cells may be collected from:

• Bone marrow – the soft, center part of bones where blood cells are made
• Peripheral blood stem cells – blood circulating in the body
• Cord blood – umbilical cord blood donated by parents after a baby is born