Children with CML - Bone Marrow Transplant

The treatment entails high dose chemotherapy and radiotherapy called TBI (total body iradiation) which destroys the cancer cells in your bone marrow and prepares you for new donor stem cells. This intense treatment also destroys your healthy stem cells.

You will usually go into an isolation room approximately 1 week prior to your transplant when your immune system is at its lowest.

The stem cells donated by someone else (a donor) are given to you by drip. The stem cells go into the bone marrow and start to produce blood cells. This helps you to recover from the high-dose treatment.

The most suitable donor is usually a brother or sister whose bone marrow is a close match to your own.

If a Brother or Sister is not a match then its possible to use stem cells from a person who is not related to you, if tests have shown that their white blood cells are a good match with yours. This is known as a matched unrelated donor (MUD) transplant. See the web links and go to Antony Nolan Trust for more information on donors.

The stem cells from a donor will contain immune cells. These immune cells can sometimes attack some of the cells of the person who has received the transplant (the recipient). This can cause a reaction in the body known as Graft Versus Host Disease (GVHD).  As well as attacking healthy cells, the immune cells from the donor may also attack any cancer cells that are left. This is known as graft-versus-disease (GvD).

An allogeneic transplant is a very serious and complicated procedure. This intensive treatment is carried out in specialised transplant units.

The main risk with transplant comes during the time after the high-dose treatment when your bone marrow is recovering. At that time, you are at risk of possible life-threatening infections and bleeding. There is also the risk of graft-versus-host disease (GVHD). Very occasionally, the donated marrow or stem cells do not start to produce new blood cells (this is called graft failure). If this happens it may be necessary for you to have more stem cells donated by the same donor.

Risks

You need to weigh up the benefits and risks of this treatment very carefully. The treatment may give a greater chance of curing the cancer than any other type of treatment. However, this has to be weighed against the possible side effects and the fact that some people die during the procedure. You will want to discuss this in detail with your doctor and your family. Most hospitals that carry out blood stem cell transplants have a transplant counsellor you can talk to about any fears or worries.