Pediatric blood and marrow transplant overview

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.

Meet The Pediatric BMT Care Team

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.