Pediatric blood and marrow transplant overview
The Fred Hutch Bone Marrow Transplant Program at Seattle Cancer Care Alliance (SCCA) is one of the world’s largest and most experienced centers for pediatric stem cell transplantation.
With every patient, we push for a perfect transplant and follow-up care. And every day, because of our experienced doctors, advanced treatments, research, and commitment, we inch closer to our goal of a lifesaving cure and a long healthy life for every child who comes to us.
Why Choose SCCA for Pediatric Transplant
- Most experienced transplant center: The Hutch pioneered the use of bone marrow transplants (BMTs) as a treatment for blood diseases more than 40 years ago. We have now performed over 16,000 BMTs, more than any other institution in the world. Nearly 20 percent of these transplants have been done in children. In 2014 the Center for International Blood and Marrow Transplant Research (CIBMTR) reported 757 allogeneic stem cell transplants were done at SCCA between January 1, 2010, and December 31, 2012, the highest volume in the nation.
- Outstanding survival results: In 2014 CIBMTR reported that SCCA was one of just 15 out of more than 165 stem cell transplant programs with a higher-than-expected one-year survival rate for patients who had an allogeneic transplant. SCCA was one of only five U.S. transplant centers to outperform in survival rates six or more times since 2005.
- Advanced transplant methods: We offer innovative transplant methods that provide your child with safer conditioning, more potent anti-cancer actions, fewer complications, and new options for those without donor matches or with noncancerous conditions. Cord blood transplants and special techniques using minimally mismatched and haploidentical stem cell sources ensure that almost all patients who need a transplant will have a donor.
- Innovative research: Thousands of scientists at the Hutch and Seattle Children’s Research Institute are working hard to translate laboratory findings into new therapies. Your child will have access to the most advanced therapies being explored in pediatric clinical studies.
- Ranked among the best: Our unmatched experience and advanced treatments have allowed us to deliver survival results that consistently rank among the best in the nation. In Seattle, your child will receive the best possible chance for a lifesaving cure.
- An expert pediatric team: Seattle is home to many of the world’s top experts in pediatric cancers, blood disorders, and transplantation. Our highly experienced team from Seattle Children’s and the Hutch — two of SCCA’s founding organizations—will coordinate and customize the transplant procedure that is exactly right for your child’s condition. We have the outstanding transplant facilities, robust family support services, and long-term follow-up programs needed to make your child’s transplant a success.
- Extraordinary support: Our many patient and family support programs help you manage all the necessary details—from travel and housing to school, insurance issues, and more.
- Long-term follow-up: Our Pediatric Long-Term Follow-Up Program helps families and children transition back home and manage any long-term transplant-related issues.
The Hutch pioneered the use of BMT as a treatment for blood diseases more than 40 years ago. Since then the Fred Hutchinson Bone Marrow Transplant Program at SCCA has established itself as one of the world’s largest and most experienced transplant centers.
- As of September 2013, the National Marrow Donor Program listed SCCA as the only U.S. center to have performed over 3,000 allogeneic transplants with unrelated donors—the most difficult type of BMT. This type accounts for nearly one of every four of the transplants we do for children.
- Over its most recent three-year review period, the Center for International Blood and Marrow Transplant Research (CIBMTR) reported 762 allogeneic stem cell transplants at SCCA, the third highest volume in the nation.
- Every year, Seattle Children’s and SCCA see more than 200 new pediatric cancer patients. According to U.S. News & World Report (2013-14), Seattle Children’s ranked #6 overall in pediatric cancer care, with the highest possible ratings for BMT survival and BMT services.
- SCCA is one of the highest-volume transplant centers for children with non-malignant disorders, such as severe aplastic anemia, myelodysplastic disorders, immune system disorders, and stem cell disorders, such as Fanconi anemia. We have performed nearly 400 BMTs for children with these disorders.
The experience and dedication of SCCA doctors, nurses, and researchers translates directly into better transplant results for our patients. With our newest transplant methods, our survival rates have improved even more in recent years.
- Over a three-year review period, CIBMTR reported that SCCA was one of just 15 stem cell transplant programs with a higher-than-expected one-year survival rate for patients who had an allogeneic transplant. SCCA was one of only five U.S. transplant centers to outperform in survival rates five or more times since 2005.
- Since 2005, the annually calculated survival rates at Seattle Children’s and SCCA for pediatric patients 100 days after their transplant ranged from 89 to 100 percent; survival rates one year after transplant ranged from 79 to 95 percent. See details on the Seattle Children’s website.
- Children with leukemia or lymphoma who are treated at Seattle Children’s, whether they have a transplant or not, have five-year survival rates higher than the national average. See details on the Seattle Children’s website.
Our doctors and scientists created many of the special BMT methods now used everyday around the world. Our latest transplant therapies, many of them available in clinical studies at SCCA, are allowing even more children with serious diseases to achieve improved long-term survival.
- With new drugs like treosulfan and other reduced-intensity strategies, we can offer safer conditioning, avoiding the high-dose chemotherapy (and sometimes radiation) typically used to prepare the body for transplant. SCCA pioneered several nonmyeloablative conditioning techniques, which reduce serious side effects such as infection but still allow the new stem cells to establish themselves and help eliminate the remaining problematic cells.
- Our new drug and immunotherapy strategies, combined with our comprehensive system of education and long-term follow-up, reduce the risk of graft-versus-host disease (GVHD), infections, and organ damage.
- We are reducing cancer relapse with novel methods, such as targeting the cancer with engineered T-cells, using tandem transplants (a pre-planned sequence of two BMTs), and employing new drug combinations or targeted therapies.
- Increasingly, our transplant methods are being adapted to help children with noncancerous conditions, such as immune disorders, aplastic anemia, sickle cell disease, Fanconi anemia, and other serious blood disorders.
- The Hutch was the first to have an unrelated donor program. This program evolved into the National Marrow Donor Program, which now helps thousands of people every year find a match outside their family. But about a third of patients still have no suitable match. Researchers from the Hutch have once again been instrumental in developing new options—half-matched (haploidentical) transplants and cord blood transplants—that make it possible for nearly anyone today to receive a transplant.
Researchers at the Hutch and Seattle Children’s are working to find the genetic and molecular roots of cancers and blood disorders and to translate their findings into improved treatments as soon as possible. Our doctors are leading many national clinical studies aimed at improving the outlook for young children and teens using these and other emerging techniques.
- We are making rapid progress with next-generation therapies, including targeted drug therapy, radiation therapy, gene therapy, and immunotherapy (including use of T-cell engineering) to attack diseases more effectively and safely.
- Our improved genetic tests and powerful data-crunching programs are guiding doctors in personalizing BMT care, predicting who is at high risk for graft-versus-host disease (GVHD) or disease relapse, improving survival, preventing side effects and relapse, and monitoring patients to ensure long-term health.
- SCCA researchers are developing immunotherapies and other BMT spin-off therapies to help an expanding array of patients with serious chronic diseases—like autoimmune disease, human immunodeficiency virus (HIV) infection, and heart disease.
Pediatric transplantation is a complex treatment drawing on many different specialties. SCCA brings all the specialists your child needs together into one smooth-running program. One pediatric specialist will manage the whole treatment plan for your child. Our experience and coordination make it easier for you to focus on your child and to trust that everything is being done according to plan.
Your child will receive care at the state-of-the-art SCCA outpatient clinic on Lake Union and at nearby Seattle Children’s, one of the most highly rated pediatric hospitals in the U.S. Children recover from their BMT in Seattle Children’s spacious new transplant wing, specially designed to be comfortable and private for families.
Families come here from all over the U.S. for transplants. Seattle Children’s and SCCA have been doing this for decades. That’s why we are so well prepared to assist your family, whether or not you already live in Seattle. To help you and your child prepare for this major life event, we offer extensive one-on-one support in arranging travel, housing, schoolwork, counseling, transportation, activities, and other practical aspects of this challenging period.
The Pediatric Long-Term Follow-Up (LTFU) Program helps families transition back home and manage potential transplant-related issues, such as issues with growth and development, as well as health problems not related to transplant. Ours is one of the most respected post-transplant care programs in the world. We currently monitor the recovery of more than 6,000 patients who had a BMT as a child at SCCA.
Since its introduction, BMT has succeeded in boosting long-term survival rates from nearly zero to more than 85 percent for several serious blood cancers in children. The newest BMT methods—such as reduced-intensity transplants, half-matched transplants, and cord blood transplants—have made the procedure available to many more children. Increasingly, children and young adults with noncancerous conditions, such as aplastic anemia, immune disorders, and autoimmune disease, are also benefitting from BMT.
What to expect
Deciding that your child should have a BMT is the first step of a long, challenging journey. We are here to support you and your family.
This section includes practical information to help families prepare for a transplant — from the first phone call to SCCA through the hospital stay and the return home.
Talk to a pediatric transplant physician
We know you are looking for answers that are specific to your child’s situation. That’s why we encourage families of children who may require a BMT to talk directly to one of our pediatric transplant specialists — by phone or in person — about their child’s condition and therapy options.
Answers to your questions
We understand that you may have many questions for us about our pediatric transplant program as well as logistically questions. We have compiled a list of frequently asked questions and their corresponding answers that may be helpful.
Parents as caregivers
For most children having a BMT, one or both parents are the primary caregivers. Although our doctors and nurses will take care of all the complex care, especially during hospitalization, your child will benefit tremendously from the constant companionship, watchfulness, and support of the primary caregiver. This close support may even allow your child to leave the hospital sooner.