Autologous transplants are generally used in the treatment of solid tumors. High doses of chemotherapy are given which not only destroys tumour cells but also healthy bone marrow cells. It will take months for healthy bone marrow cells to recover and the risk of infection is very high during this period of recovery. Your child will undergo stem cell collection if BMT is part of his/her treatment protocol. Your child's own stem cells are collected, cryopreserved (frozen), and stored in a lab at the BCCH site.  When the stem cells are due to be infused, the cells are thawed and re-infused directly into your child.

Donors are assessed by a special typing called human leukocyte antigen (HLA) typing, and these antigens (or proteins) are inherited as a grouping from each biological parent.  Therefore, the best chance for well-matched donors is from a full sibling. Otherwise, an alternative donor may be used either from a cord blood bank or from unrelated adult donor registries e.g. OneMatch. Using a fully matched donor decreases the risk of engraftment failure (failure of the new stem cells to make healthy blood cells) as well as graft vs host disease (GVHD). 

There are two forms of GVHD, an early form (acute) and late-onset form called Chronic GVHD.

In the first few months after the transplant, acute GVHD can develop as an immune response against the skin (rash), the gut (diarrhea or pain), or the liver (increased liver enzymes and jaundice).  This can be a potentially debilitating and devastating condition.  It is generally treated with systemic steroids, and/or immune suppressive therapy.

Chronic GVHD develops slowly and is very slow to resolve.  Sometimes it never goes away.  Chronic GVHD is a very complicated disease and can affect any organ or tissue in the body.  We have been able to significantly decrease the impact of GVHD partially by using various medications.