Blood and Marrow Transplant

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Norton Children’s Cancer Institute, affiliated with the UofL School of Medicine, has been home to the Hanna Catherine Evans Bone Marrow and Stem Cell Transplant Program since 1993. It is the region’s only blood and marrow transplant program dedicated to helping kids. The program is made up of a dedicated team of clinicians and supporting staff specially trained to provide comprehensive care to pediatric patients who need blood and bone marrow transplants.

Norton Children’s Hospital is a member of the Pediatric Blood & Marrow Transplant Consortium and the Blood and Marrow Transplant Clinical Trials Network. It also is accredited by the Foundation for the Accreditation of Cellular Therapy for high-quality care of transplant patients.

What Is a Blood and Marrow Transplant?

The purpose of a blood and marrow transplant, or blood stem cell transplant, is to replace diseased bone marrow with healthy marrow. Marrow is the spongy material in the center of bones that contains blood stem cells, immature but versatile mother cells from which red blood cells, white blood cells and platelets develop.

Bone marrow makes three types of blood cells:

  • Red blood cells, which are the oxygen carriers in the body
  • White blood cells, which are infection-fighting cells
  • Platelets, which help form clots to stop bleeding

Blood and marrow transplantation uses stem cells obtained from:

  • Bone marrow
  • Blood stem cells collected from peripheral blood
  • Blood stem cells obtained from the umbilical cord

There are two types of stem cell transplants:

  • Autologous – Using the child’s own stem cells
  • Allogeneic – Using stem cells from either a family member or an unrelated donor

The type of transplant needed depends on a child’s particular disease. Diseases treated by transplant include, but are not limited to:

  • Acute lymphoblastic leukemia (ALL)
  • Acute myelogenous leukemia (AML)
  • Aplastic anemia
  • Hemophagocytic lymphohistiocytosis
  • Neuroblastoma
  • Lymphomas
  • Brain tumors, such as medulloblastoma
  • Relapsed or refractory solid tumors, such as Ewing sarcoma
  • Sickle cell disease
  • Primary immunodeficiency diseases

A patient who needs a blood or marrow transplant will usually first receive several days of chemotherapy to prepare the body to accept the donor stem cells. The donor cells then will be transplanted into the patient through a simple infusion into a vein. Replacing the patient’s blood system with heathy donor blood cells will usually happen about three to four weeks afterward. Our providers will closely monitor patients during this time to watch for any transplant-related side effects.

Blood and Marrow Transplant Program at Norton Children’s Cancer Institute

Our blood and marrow transplant team uses a holistic approach to providing transplant care to our patients, paying attention to both the physical and psychosocial aspects of care. The transplant team works closely with the patient’s own primary oncology team to select the best transplant regimen, performs meticulous donor searches to identify the most suitable donor and conducts extensive educational activities with the family to familiarize them with the transplant process.

An integrated team of clinicians, nurses, child life specialists, physical therapists, social workers and psychologists work intimately with each patient and family to manage acute medical issues and alleviate anxiety and discomfort. Usually, by the end of the transplant process, the team and the patient’s family will have become close partners working together to provide seamless care.

Even though blood and marrow transplantation is a complex procedure that could carry serious side effects, enhancements in quality assurance and supportive care have improved the overall clinical outcome.

The Hanna Catherine Evans Bone Marrow and Stem Cell Transplant Program is led by William T. Tse, M.D., Ph.D. Dr. Tse trained at Yale, Stanford and Harvard universities, and brings outstanding new visions and abundant experience in blood and marrow transplant and cellular therapy. Our team is proud to be committed to providing this type of specialized care.

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