Reasons for a blood and marrow transplant

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Parents can find out if their child is a candidate for a blood and marrow transplant (BMT).

Key points

  • If a child is undergoing high-dose chemotherapy, they may have a BMT to help their immune system recover.
  • A BMT may be given as immunotherapy if a child relapses with cancer.
  • Some genetic disorders may be treated by BMT.

Your child may need a blood and marrow transplant (BMT) for many reasons including if your child is undergoing chemotherapy and immuno-therapy to treat cancer. A BMT may also be used to treat bone marrow deficiencies caused by genetic disorders.

High-dose chemotherapy to treat cancer

Sometimes doctors need to use high-dose chemotherapy to treat children who have cancer. This is often the case with high-risk leukemia or lymphoma. Along with killing the cancerous cells, high-dose chemotherapy also kills healthy blood cells inside the bone marrow. Transferring a new, healthy set of blood stem cells using a BMT is an option for these children. It allows their immune systems to recover from the intense treatment.

Immuno-therapy to treat cancer

Doctors sometimes give BMT as a treatment option for children who relapse with cancer. To do this, they inject the child with donor white blood cells called T-cells, which fight infection. Because the goal of the transplant is to create an immune response inside the patient, it is called an immunotherapy.

How immunotherapy works

T-cells recognize which cells belong inside the body and which do not. When transplanted into your child, the donor T-cells also target and help destroy any diseased marrow cells left inside your child’s body. This is called the graft vs leukemia effect (GVL). Studies show that GVL can help lower the risk of relapse by infusing patients with more donor T-cells. Because of its effectiveness, researchers combine GVL with ‘mini-transplants’ which involve lower-doses of chemotherapy and radiation.

Treating bone marrow deficiencies caused by genetic disorders

Your child may be receiving a BMT because their marrow cells do not work properly. Having deficient marrow cells are often caused by genetic disorders.

Some genetic disorders that are treated by BMT include:

  • severe aplastic anemia
  • hemoglobinopathy
  • sickle cell anemia
  • thalassemia
  • genetic disorders that disrupt how the metabolism works, for example, Hurler syndrome
  • severe immunodeficiency syndromes
Last updated: February 12th 2010