Bone Marrow Transplant - Children

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Transplant Definitions

Acute lymphoblastic leukemia (ALL)
ALL is the most common form of childhood leukemia, a cancer of the white blood cells that invades the bone marrow and crowds out normal, healthy blood cells.

Acute myelogenous leukemia (AML)
Like other types of leukemia, AML is a cancer of the white blood cells. AML is a type of leukemia that progresses fairly quickly. It is characterized by the growth of too many immature white blood cells in the blood and bone marrow.

Acute promyelocytic leukemia (APL)
APL is a subtype of acute myelogenous leukemia (AML) in which normal blood cells are replaced by abnormal cells called promyelocytes.

Aplastic anemia
Aplastic anemia is a condition in which the bone marrow stops producing new blood cells.

Autoimmune disorders
Autoimmune disorders are conditions in which the body’s immune system attacks its own cells, causing tissue destruction.

Brain tumors
Brain and spinal cord tumors are the most common solid tumors found in children. There are various types, including medulloblastomas, astroyctomas, ependymomas, primitive neuroectodermal tumors and oligondendrogliomas.

Central line
This is also called a “central intravenous catheter.” It is a small, flexible tube inserted into a large vein near the heart. It is used to give your child medications and to draw blood. It is also used to give the stem cells during your child’s transplant.

Chronic myelogenous leukemia (CML)
Like other types of leukemia, CML is a cancer of the bone marrow. It is a slowly progressing disease in which too many white blood cells are made in the bone marrow, crowding out normal, healthy blood cells.

Conditioning therapy
This is a treatment given before a bone marrow or stem cell transplant to kill cancer cells and prepare the patient’s bone marrow to receive the transplant. Conditioning therapy may include chemotherapy, radiation therapy or both types of treatment.

When your child’s doctor or nurse talks about “monitoring your child’s counts,” they are usually referring to monitoring the absolute neutrophil count (ANC) while watching for signs of engraftment.

Engraftment is the process in which the transplanted stem cells begin to function and start producing new blood cells.

Ewing’s sarcoma
Ewing’s sarcoma is a type of bone cancer that is usually found in the shaft of large bones.

Fanconi anemia
This form of anemia is inherited and can lead to aplastic anemia, or bone marrow failure.

Graft-versus-host disease (GVHD)
GVHD is a common side effect of transplants. GVHD occurs when the transplanted donor cells recognize the patient’s tissues as foreign and attack the tissues. This can cause a variety of problems, including skin rashes, liver problems and diarrhea. If your child has chronic GVHD, he or she will be taking medications such as prednisone and cyclosporine to suppress the immune system to prevent these problems. Sometimes children develop symptoms of GVHD after they return home. Contact the Long-Term Follow-Up team at (206) 667-4415 if your child develops problems such as dry and scaly skin, dry eyes or mouth, mouth lesions, weight loss, fatigue or bacterial infections. Your “Patient & Caregiver Resource Manual” contains a complete list of physical changes that should be reported to your child’s doctor.

Hereditary blood disorders
These include sickle cell disease; thalassemia, an inherited type of anemia found most commonly among people of Mediterranean descent; and amegakaryocytic thrombocytopenia, an inherited disorder that predisposes a child to aplastic anemia.

Immunodeficiency syndromes
These include severe combined immunodeficiencies (a group of rare inherited disorders characterized by little, if any, immune response) and Wiskott-Aldrich syndrome (a genetic disease that affects male children because the defect that causes it is on the X chromosome). Wiskott-Aldrich syndrome is characterized by a low level of blood platelets, a high risk of leukemia and other problems.

Inborn errors of metabolism
Inborn errors of metabolism include a number of genetic disorders that are caused by a deficiency of a specific substance, usually a protein, in the body. Inborn errors of metabolism that can be treated with a bone marrow or stem cell transplant include adrenoleukodystrophy, Hurler’s mucopolysaccharidosis, Krabbe’s disease and metachromatic leukodystrophy.

Juvenile rheumatoid arthritis (JRA)
This form of arthritis affects children up to age 17 and causes joint inflammation and stiffness. One type of JRA can also affect internal organs. This is an autoimmune condition, which means the child’s immune system regards some of the body’s cells as foreign and attacks them.

Non-Hodgkin's lymphoma is the most common form of lymphoma found in children. Lymphomas are cancers found in the lymph system—the body’s disease- and infection-fighting network.

Myelodysplastic syndrome (MDS)
MDS is a disease in which the bone marrow does not function normally, affecting the production of all three major types of blood cells: red blood cells, white blood cells and platelets. It is also sometimes called preleukemia or smoldering leukemia.

Neuroblastomas are fast-growing cancers that develop from nerve cells and typically arise in the adrenal glands. Neuroblastomas attack very young children, many before they reach 1 year of age.

Oral mucositis
Conditioning therapy will cause your child’s mouth to be very sore. This is called “oral mucositis.” It is a temporary condition that will begin to heal when the new bone marrow begins to make white blood cells.

Severe combined immunodeficiencies
This refers to a group of rare inherited disorders characterized by little, if any, immune response.

Sickle cell disease
Sickle cell disease is an inherited disease characterized by abnormal red blood cells. The red blood cells become crescent (sickle) shaped and, as a result, function abnormally.

Systemic lupus erythematosis
Lupus is an autoimmune disease that can affect many tissues and cause inflammation throughout the body. Most often lupus causes fatigue; painful, swollen joints; fever; rash; and kidney problems. It is more common in women than men, and more common in African-American women than women of other racial or ethnic backgrounds.

Systemic sclerosis (scleroderma)
In this autoimmune disease, scarring, or fibrosis occurs in the skin and other organs. This can be felt as thickening or firmness. In some cases, the effects are limited, usually to the face and fingers. In other cases, the disease is more diffuse, affecting tissues throughout the body.

Thalassemia is an inherited problem with red blood cells. It can cause anemia (low levels of red blood cells). People with thalassemia do not create enough hemoglobin. This may mean their body does not make enough red blood cells to begin with, their red blood cells break down more quickly than normal, their red blood cells are smaller than normal, or they have less hemoglobin in their red blood cells than normal.

Total body irradiation (TBI)
TBI is a radiation treatment to the entire body. It is used to destroy cancer cells and bone marrow cells in preparation for a bone marrow or stem cell transplant.

Veno-occlusive disease (VOC)
VOC is a complication of transplantation in which the liver’s cannot remove waste products from the body as well as it should. It is most likely to occur during the first month after a transplant.

Wilms’ tumor
Wilms’ tumor is a fast-growing tumor of the kidney that can metastasize to the lungs. It usually appears in children between the ages of 2 and 4.