Blood and Marrow Transplant/Cellular Therapy Patient and Family Resources
We generally use autologous transplants to treat solid tumours.
We give high doses of chemotherapy, which not only destroys tumour cells but also healthy bone marrow cells.
We then thaw the patient's own stem cells, which we have previously collected and frozen, and infuse them into the same patient to help them recover from the high doses of chemotherapy.
Your physician will discuss this procedure with you in detail if it is part of your child's protocol.
Allogeneic transplant uses stem cells from someone other than the patient.
Through a special typing process called human leukocyte antigen (HLA) typing, we can find an appropriate stem cell donor for most patients. HLAs are inherited in groupings from biological parents, so the best chance for fully-matched donors is from a full sibling.
If there is no sibling donor, we can use an alternative donor from the unrelated donor registry (e.g. One Match). Using a fully matched donor decreases several transplant-related complications, such as graft vs host disease (GVHD).
If allogeneic BMT is in your child's protocol, your physician and health care team will discuss this procedure with you in depth prior to the infusion.
Graft vs host disease (GVHD)
There are two forms of GVHD: an early form (acute) and a 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). We generally treat it with systemic steroids and/or immune suppressive therapy.
Chronic GVHD (cGVHD) develops more slowly and can be very slow to resolve. It is also an immune response from the donor immune system fighting against the recipient's (patient's) body tissues.
Chronic GVHD is a complicated disease and can affect any organ or tissue in the body, but most often will affect the skin, joints, eyes and/or mouth. Treatment generally involves steroids and immune suppression.
If you suspect cGVHD in your child who has had an allogeneic BMT, it is very important to report signs of GVHD early to your health care team so we can diagnose and treat it as early as possible. cGVHD symptoms can include:
- Skin problems such as dryness, rash, itching, peeling, darkening, hard texture and feeling tight
- Dry eyes that may have a burning or gritty feeling
- A dry mouth with or without mouth ulcers
- Diarrhea, loss of appetite, stomach cramps, vomiting
- Pain in muscles and joints
- Infections
- Weight loss
- Difficulty breathing
T-cell therapy is a newer method of treating cancer. In this therapy, we take the patient's own cells, specifically the T-cells, from the patient's own blood and genetically modify them in the lab to recognize a target on the patient's cancer cells.
We then infuse the cells back into the patient. The cells' job is now to recognize the cancer cells, bind to them and destroy them.
The patient may or may not require an allogeneic BMT after the CAR T-cell therapy.
BC Children's Hospital pamphlets
- Frequently Asked Questions: Autologous blood and marrow transplants (PDF, reviewed February 2020)
- Going Home After an Autologous Blood and Marrow Transplant (PDF, reviewed January 2023)
- Frequently Asked Questions: Allogeneic blood and marrow transplants (PDF, reviewed February 2020)
- Going Home After an Allogeneic Blood and Marrow Transplant (PDF, reviewed January 2023)
- Blood and Marrow Transplant Diet Guidelines (PDF, reviewed 2024)
Websites
- Blood and Marrow Transplant Learning Hub (SickKids)
- Me and My Marrow: A Kid's Guide to Bone Marrow Transplant (PDF)
- Blood and Marrow Transplant Information Network
- CAR T-Cell Therapy (Children's Hospital of Philadelphia)
Blood and marrow transplant team
The transplant team will have a blood and marrow transplant (BMT) meeting with the families if BMT transplant is part of a treatment protocol or recommended to treat your child's illness.
Contact: bmtnurse@cw.bc.ca