Pediatric Stem Cell Transplantation Treatment and Clinical Trials

What is a stem cell transplant?

How stem cells are obtained

Stem cells used for transplantation can be obtained from bone marrow, umbilical cord blood, or mobilized peripheral blood. Stem cells can be obtained from the bone marrow in the operating room under general anesthesia or from the peripheral blood by a process called apheresis, where the stem cells are collected and the rest of the blood is then returned to the donor. Cord blood is collected at the time of delivery from volunteer mothers and frozen until it is used.

Allogeneic stem cells

Allogeneic stem cells are collected from a related or unrelated donor. The allogeneic donor is chosen to be as genetically close to your child as possible. The best donor is a brother or sister who has the same HLA antigens (genes that make proteins that help the body differentiate between “self” and “other”) as your child. Siblings have a 25 percent chance of being such a donor. If a brother or sister cannot be a donor, we contact the National Marrow Donor Program (NMDP) to see if an unrelated volunteer donor has HLA typing similar to that of your child, and therefore, could be used as a stem cell donor. In cases when an unrelated donor cannot be identified, the father or mother (who have 50 percent of the same genes as the patient) can be used in a haploidentical transplant or unrelated cord blood can be used as a source of stem cells.

Autologous stem cells

For some forms of cancer, your child’s own stem cells can be collected from the bone marrow or peripheral blood and used for transplant.

Pre-transplant therapy

Before transplantation, your child will receive therapy to destroy the cancer or abnormal stem cells and allow normal stem cells to grow. The specific therapy that is administered will depend upon your child’s disease and clinical history. Our doctors are testing new approaches to use antibodies as an alternative to chemotherapy to prepare your child’s body for transplant.

Hospital stay

After the completion of pre-transplant therapy, the stem cells are infused into your child’s vein where they can travel to your child’s bone marrow. Your child must remain in the hospital's Stem Cell Transplant Unit until the donor stem cells have grown enough to permit your child to safely leave the hospital, usually 1 to 2 months after the transplant.