A bone marrow transplant or stem cell transplant is a treatment for some types of cancer and bone marrow problems. Marrow is the soft, fatty tissue inside the hard bone. The marrow is where blood cells are formed.
Stem cells are young blood cells that can become red blood cells, white blood cells, or platelets. Most stem cells are in the bone marrow, but some are in the bloodstream. Blood in the human newborn umbilical cord also contains stem cells. Stem cells from any of these sources can be used for transplants.
A bone marrow or stem cell transplant may be done to:
Stem cell transplants may be used to treat:
Researchers are studying stem cell transplants to see if they will help with other diseases.
The bone marrow or stem cells are collected from a donor or from your child’s blood before he has chemotherapy or radiation therapy.
Before stem cells are collected from your child’s blood, he will be given medicine for a few days to help his body make more blood forming cells. Stem cells will be taken from a large vein in your child’s arm or through a tube placed in a vein in his neck, chest, or groin. The blood goes through a machine that separates the stem cells from the rest of the blood. The remaining blood is returned to your child through another vein. Collecting stem cells from your child’s blood takes about 4 to 6 hours. It can be done at an outpatient clinic. Stem cells can be frozen and stored until they are needed.
Bone marrow is usually collected from both hipbones with a needle. Your child will be given regional or general to keep him from feeling pain during the procedure. Regional anesthesia numbs part of the body while your child stays awake. General anesthesia relaxes your child’s muscles and puts your child into a deep sleep. The procedure to collect bone marrow takes about an hour.
When it is time for the transplant, the bone marrow or stem cells are given through a vein (IV), like a blood transfusion. The transplant takes 1 to 5 hours.
The medicine used to help your child’s body make more blood forming cells may cause side effects such as fever, bone and muscle aches, headaches, tiredness, nausea, vomiting, and trouble sleeping. These side effects generally go away in 2 to 3 days after the last dose of the medicine.
After your child donates bone marrow, the area where the marrow was taken out may feel stiff or sore for a few days, and your child may feel tired. Within a few weeks, his body will replace the donated marrow. Some children are back to their usual routine within 2 or 3 days, but others may need 3 to 4 weeks to fully recover their strength.
When your child is given a transplant, the stem cells start to make new, healthy blood cells in 2 to 4 weeks. During this time, your child may be given medicine or blood transfusions to prevent problems.
After the transplant, your child will have blood tests to see how well his bone marrow is making new blood cells. Your child may also have a test called bone marrow aspiration, which is the removal of a small sample of bone marrow through a needle for examination under a microscope. This helps your provider see how well your child’s bone marrow is producing new cells and platelets.
Although your child’s body will start making new blood cells in 2 to 4 weeks, it will take much longer for his immune system to recover completely. It could take up to several months if his own stem cells are used and 1 to 2 years if the stem cells were donated by someone else. Your child may need to stay away from school and other places due to the danger from infections such as colds and flu.
If your child’s own cells are used for the transplant, there are usually no serious risks other than the risks of the general or regional anesthesia used during the procedure. Discuss the risks of anesthesia with your healthcare provider. When your child receives his own stem cells in a transplant, there is no risk from anesthesia because anesthesia is not needed.
When your child receives cells from another person:
Ask your healthcare provider how these risks apply to your child. Be sure to discuss any other questions or concerns that you may have.
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