Treatments

Pediatric blood and marrow transplant

At the Pediatric Blood and Marrow Transplant Program at Fred Hutchinson Cancer Center, your child will receive world-class care. Our program is one of the largest, most experienced and most respected centers for pediatric blood and marrow transplant (BMT) in the world.

Our experts from Seattle Children’s and Fred Hutch begin by developing a personalized BMT plan for your child. They continue to stand by you as your child goes through treatment, recovery and beyond with our family support services and lifetime Pediatric Long-Term Follow-Up (LTFU) Program. By working together, we make sure your child and family receive the right care for the rest of your child’s life.

Bone marrow transplant The process of treating disease with high doses of chemotherapy, radiation therapy or both. Bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. The process of treating disease with high doses of chemotherapy, radiation therapy or both. Because this treatment destroys the bone marrow’s ability to produce blood cells, bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells.
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We're moving!

The Pediatric Blood and Marrow Transplant clinic is moving from Fred Hutch to Seattle Children’s Hospital in fall 2022.

If your child has an upcoming appointment on Oct. 17, 2022, or later, please note that your visit will take place in the new location at Seattle Children's Hospital. If you have any questions, please contact your care team.

Beginning Oct. 17, 2022, the new address for the Pediatric Blood and Marrow Transplant outpatient clinic will be: 

Seattle Children’s Hospital 
Forest B, Level 7
4800 Sand Point Way NE, Seattle, WA 98105
Parking: Forest Garage  

Leading the way

The world’s first bone marrow transplant happened in the 1970s, when one of our leading physician-researchers, E. Donnall Thomas, MD, and his team developed the clinical use of transplants — and won a Nobel Prize for this work. 

Since then, our physicians and scientists have carried this work forward, creating many of the BMT methods now used in treatment centers around the world. The latest transplant therapies allow even more children and adults with serious diseases to be successfully treated, and many of them are available through our clinical trials. 

Fred Hutch was also the first to establish an unrelated donor program. This program became the National Marrow Donor Program, which now helps thousands of people every year find a match outside their family. 

Where treatment happens

Your child will be treated at South Lake Union clinic and nearby Seattle Children’s, one of the most highly rated pediatric hospitals in the U.S. After their BMT, your child will recover in Seattle Children’s large transplant wing, specially designed for children and families just like yours.
 

Bone marrow The soft, spongy material in the center of your bones that produces all your blood cells, such as white blood cells, red blood cells and platelets. Bone marrow transplant The process of treating disease with high doses of chemotherapy, radiation therapy or both. Bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. The process of treating disease with high doses of chemotherapy, radiation therapy or both. Because this treatment destroys the bone marrow’s ability to produce blood cells, bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells.

Frequently asked questions (FAQs)

What is a BMT?

A BMT restarts your body’s ability to make healthy new blood cells by replacing abnormally forming stem cells with healthy cells.

What is conditioning?

Conditioning is when a patient receives chemotherapy, radiation or both before a BMT. This is done to destroy or weaken the damaged cells in their body. 

Bone marrow transplant The process of treating disease with high doses of chemotherapy, radiation therapy or both. Bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. The process of treating disease with high doses of chemotherapy, radiation therapy or both. Because this treatment destroys the bone marrow’s ability to produce blood cells, bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Conditioning Treatments to prepare patients for stem cell transplantation. May include chemotherapy, monoclonal antibody therapy and radiation. The treatments used to prepare a patient for stem cell transplantation (a procedure in which a person receives blood stem cells, which make any type of blood cell). A conditioning regimen may include chemotherapy, monoclonal antibody therapy and radiation to the entire body. It helps make room in the patient’s bone marrow for new blood stem cells to grow; prevent the patient's body from rejecting the transplanted cells; and kill any cancer cells that are in the body.
Why is BMT needed?

Sometimes the amount of radiation, chemotherapy or both that is needed to treat a cancer is so high that a patient’s stem cells will be badly damaged or destroyed by these treatments. Other times, bone marrow can be destroyed by a disease. BMT replaces these damaged cells with healthy new cells.

Bone marrow The soft, spongy material in the center of your bones that produces all your blood cells, such as white blood cells, red blood cells and platelets. Bone marrow transplant The process of treating disease with high doses of chemotherapy, radiation therapy or both. Bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. The process of treating disease with high doses of chemotherapy, radiation therapy or both. Because this treatment destroys the bone marrow’s ability to produce blood cells, bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Stem cell A cell from which other types of cells develop. For example, blood cells develop from blood-forming stem cells.
Where do you get the cells to transplant?

The cells that are transplanted, called hematopoietic (blood-forming) stem cells, can come from bone marrow, circulating blood or umbilical cord blood donated by a new mother.

Bone marrow The soft, spongy material in the center of your bones that produces all your blood cells, such as white blood cells, red blood cells and platelets. Stem cell A cell from which other types of cells develop. For example, blood cells develop from blood-forming stem cells.
What types of pediatric cancers can be treated with BMT?

BMT is often used to treat pediatric cancers like leukemia or lymphoma that cause a child’s bone marrow to make too many blood cells or the wrong type of blood cells.

Bone marrow The soft, spongy material in the center of your bones that produces all your blood cells, such as white blood cells, red blood cells and platelets. Bone marrow transplant The process of treating disease with high doses of chemotherapy, radiation therapy or both. Bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. The process of treating disease with high doses of chemotherapy, radiation therapy or both. Because this treatment destroys the bone marrow’s ability to produce blood cells, bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. Lymphoma Cancer that begins in the cells of the immune system. There are two basic categories of lymphomas: Hodgkin lymphoma and non-Hodgkin lymphomas. Cancer that begins in cells of the immune system. There are two basic categories of lymphomas. One is Hodgkin lymphoma, which is marked by the presence of a type of cell called the Reed-Sternberg cell. The other category is non-Hodgkin lymphomas, which includes a large, diverse group of cancers of immune system cells. Non-Hodgkin lymphomas can be further divided into cancers that have an indolent (slow-growing) course and those that have an aggressive (fast-growing) course. These subtypes behave and respond to treatment differently. Both Hodgkin and non-Hodgkin lymphomas can occur in children and adults, and prognosis and treatment depend on the stage and the type of cancer.
What other childhood diseases are treated with BMT?

At SCCA, we use BMT to treat children when their marrow stops making new blood cells (called severe aplastic anemia) or when certain blood cells aren’t working right (such as defective white blood cells in immune deficiencies, overaggressive white blood cells in autoimmune diseases, or misshaped red blood cells like those found in sickle cell disease). 

We also use BMT to treat other rare pediatric diseases, such as high-risk neuroblastoma, and nonmalignant diseases, such as Fanconi anemia, scleroderma and juvenile idiopathic arthritis (JIA).

Anemia A condition in which the number of red blood cells is below normal. Benign Not cancer. Benign tumors may grow larger but do not spread to other parts of the body. Bone marrow transplant The process of treating disease with high doses of chemotherapy, radiation therapy or both. Bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. The process of treating disease with high doses of chemotherapy, radiation therapy or both. Because this treatment destroys the bone marrow’s ability to produce blood cells, bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. Fanconi anemia A rare inherited disorder in which the bone marrow does not make enough blood cells, including red blood cells, white blood cells and platelets. It is usually diagnosed before age 15. A rare inherited disorder in which the bone marrow does not make enough blood cells, including red blood cells, white blood cells and platelets. It is usually diagnosed before age 15. Signs and symptoms include frequent infections, a tendency to bleed easily and extreme tiredness. People with Fanconi anemia may also have brown spots on the skin, short height, malformed thumbs or forearms, a small head or eyes and hearing loss, as well as abnormalities of the kidneys, gastrointestinal tract, heart, genitals, brain and spinal cord. They also have an increased risk of developing certain types of cancer, including leukemia and cancers of the skin, head, neck, gastrointestinal system and genitals. Fanconi anemia is caused by mutations (changes) in certain genes involved in DNA repair. Neuroblastoma Cancer that forms from immature nerve cells. Usually begins in the adrenal glands but may begin in the abdomen, chest or nerve tissue near the spine. Most often occurs in children younger than age 5. A type of cancer that forms from immature nerve cells. It usually begins in the adrenal glands but may also begin in the abdomen, chest, or in nerve tissue near the spine. Neuroblastoma most often occurs in children younger than 5 years of age. It is thought to begin before birth. It is usually found when the tumor begins to grow and cause signs or symptoms. Red blood cell A type of blood cell that carries oxygen in the body. Scleroderma A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized, or it can affect the entire body (systemic). Sickle cell disease An inherited disease in which the red blood cells have an abnormal crescent shape, block small blood vessels and do not last as long as normal red blood cells. An inherited disease in which the red blood cells have an abnormal crescent shape, block small blood vessels and do not last as long as normal red blood cells. Sickle cell disease is caused by a mutation (change) in one of the genes for hemoglobin, which is the substance inside red blood cells that binds to oxygen and carries it from the lungs to the tissues. It is most common in people of West and Central African descent. Also called sickle cell anemia.
What are the different types of BMTs?

Allogeneic: When healthy stem cells used in a transplant come from a donor, it is called an allogeneic transplant. 

Autologous: When healthy stem cells come from a patient’s own body, it is called an autologous transplant.

Blood/stem cell: When the healthy stem cells come from a patient’s own blood (autologous) or a healthy donor’s blood (allogeneic), it is called a blood/stem cell transplant. These are the most common type of transplants. 

Bone marrow: When healthy stem cells come from a healthy donor’s bone marrow, it is called a bone marrow transplant. 

Cord blood: After a baby is born, parents can choose to donate their umbilical cord. The blood from the cord is frozen, then stored in a cord blood bank until it is used in a transplant. A cord blood transplant is a type of allogeneic transplant. 

Haploidentical (haplo): Sometimes a parent, sibling or child can be a donor, even if they are not a very close match to the patient. In a haploidentical transplant, these first-degree relatives only need to be a 50 percent match to the patient.

Fred Hutch Blood and Marrow Transplant Pediatric Program
phone (800) 804-8824
Monday–Friday, 6:30 am–6 pm
fax (206) 606-1025

Your initial consultation

You will begin with an initial consultation with a transplant specialist, who will talk with you about your child’s treatment options and make recommendations for you and your referring physician. This appointment can be in person or through telehealth.

If the appointment is in person, you’ll also meet with a transplant nurse, who will tell you more about BMT and give you a tour of the South Lake Union clinic. This is also a time for us to get to know you and your child better and answer any questions you may have. 

Bone marrow transplant The process of treating disease with high doses of chemotherapy, radiation therapy or both. Bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. The process of treating disease with high doses of chemotherapy, radiation therapy or both. Because this treatment destroys the bone marrow’s ability to produce blood cells, bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells.

Care at Fred Hutch

Your Fred Hutch transplant team is here to treat your child, to listen to you and to take care of your child and family. They are BMT experts who focus exclusively on treating children just like yours, every day, who are going through BMT. 

About your transplant team

Your child’s team includes a group of world-class professionals including a transplant physician, transplant nurse, advanced practice provider, pharmacist, registered dietitian, team coordinator and social worker, all here to support your child and family. We also offer supportive care services to help your child’s well-being in every sense. 
 

Bone marrow transplant The process of treating disease with high doses of chemotherapy, radiation therapy or both. Bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. The process of treating disease with high doses of chemotherapy, radiation therapy or both. Because this treatment destroys the bone marrow’s ability to produce blood cells, bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells.

Transplant path

BMT involves several steps. It will take about four months if your child is receiving cells from a donor and about two months if your child’s own cells will be used. 

After your initial consultation, the next step is finding a stem cell donor for your child, if they need one, or preparing to have your child’s stem cells collected for use in their transplant later. We will guide you, step by step, as you get ready.

When you arrive at Fred Hutch, the pediatric BMT team thoroughly evaluates your child’s health before providing their conditioning treatment (chemotherapy, radiation or both). 

Next, your child will go to Seattle Children’s for their transplant infusion. After the infusion, your child will stay at the hospital, and we will carefully monitor them as their bone marrow and immune system recover. We will continue to support you and your family until your child is ready to go home and return to your referring physician’s care.

When it’s time to go home, we will make sure you and your child feel ready and we will talk to you about joining our Pediatric Long-Term Follow-Up (LTFU) Program.
 

Bone marrow The soft, spongy material in the center of your bones that produces all your blood cells, such as white blood cells, red blood cells and platelets. Bone marrow transplant The process of treating disease with high doses of chemotherapy, radiation therapy or both. Bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. The process of treating disease with high doses of chemotherapy, radiation therapy or both. Because this treatment destroys the bone marrow’s ability to produce blood cells, bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. Conditioning Treatments to prepare patients for stem cell transplantation. May include chemotherapy, monoclonal antibody therapy and radiation. The treatments used to prepare a patient for stem cell transplantation (a procedure in which a person receives blood stem cells, which make any type of blood cell). A conditioning regimen may include chemotherapy, monoclonal antibody therapy and radiation to the entire body. It helps make room in the patient’s bone marrow for new blood stem cells to grow; prevent the patient's body from rejecting the transplanted cells; and kill any cancer cells that are in the body. Infusion An injection of medications or fluids into a vein over a period of time. Stem cell A cell from which other types of cells develop. For example, blood cells develop from blood-forming stem cells. Stem cell A cell from which other types of cells develop. For example, blood cells develop from blood-forming stem cells.

Other resources

Long-Term Follow-Up Program
Long-Term Follow-Up Program

Our Long-Term Follow-Up (LTFU) Program is one of the most respected post-transplant care programs in the world, helping families transition back home after a child has recovered. The LTFU program will help you manage any transplant-related issues, such as problems related to growth and development, as well as health problems that are not related to transplant. 

Care team
Care team

At SCCA, our team of dedicated BMT experts give your child and family the highest level of care and support. You’re part of the care team, too. And your child and family are at the center of everything we do.

Research
Research

More than 50 years ago, Nobel Prize-winner E. Donnall Thomas, MD, and his team at Fred Hutch first developed clinical use of transplants. Today, the world-famous physician-scientists at Fred Hutch Blood and Marrow Transplant Program at SCCA continue to lead the way.

Caregivers and BMT
Caregivers and BMT

As part of planning for your child’s transplant, it is important to understand what caregivers do. If a parent cannot be a caregiver, another responsible adult family member or friend will need to take on this role and stay with the child during treatment and recovery.