What is a stem cell transplant?
A stem cell transplant is an infusion of healthy hematopoietic stem cells in order to treat certain types of cancer, blood diseases and other conditions. Hematopoietic stem cells are a special type of cell found in the bone marrow that can form any type of blood cell: red blood cells, white blood cells and platelets. This is different from pluripotent or embryonic stem cells, which can form any type of cell in the body.
The cells for a stem cell transplant, also called a bone marrow transplant, can come from a related donor such as a sibling, an unrelated donor or from the patient themselves. The stem cells are injected into your child’s bloodstream and travel to the bone marrow where they begin to make new blood cells.
How do I find a matched donor for my child?
If your child needs stem cells from someone else, we will determine the best donor possible using HLA-typing, a process that is used to detect your child’s transplant antigens. Antigens are "fingerprints" on the surface of almost all cells of the body.
It’s best to find a donor whose HLA-type is as similar as possible to your child’s. We begin by testing your child and immediate family members.
- Matched or closely matched family donor: About 25 percent of patients have a family member who is a match at the six major sites tested. If a member of your family matches in five or six of the areas, he or she may be selected as a donor.
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Unrelated donor: If no acceptable match is found within your family, the transplant team may conduct a preliminary search for an unrelated donor through the National Marrow Donor Program (NMDP) and more than 46 international and cord bank computerized database registries. The preliminary search of the donor database is free.
The transplant team will then ask registries to contact potential matched donors for further testing, which requires insurance coverage or a financial down-payment. The transplant team meets at least weekly to review the status of the donor search, and the Stem Cell Transplant Patient Coordinator will update you and your family on a regular basis.
- Mismatched family and haploidentical transplant: Some patients will not have an acceptable donor in the registries. Researchers are currently investigating the possibility of using family members as donors even if they are not a close enough match for a traditional transplant. This type of transplant is called a haploidentical transplant.
Any family member between the ages of 17 and 60 who has been HLA tested at Dana-Farber Cancer Institute may enroll in the NMDP by contacting the NMDP Donor Center at 617-632-2561.
How does a stem cell transplant work?
Stem cells are injected via IV into your child’s blood stream. They make their way into your child’s bone marrow and replace the cells that used to be there. Eventually, these stem cells begin to make new, healthy blood cells. The transplant replaces stem cells that were damaged or defective and, as a result, can cure certain cancers, blood diseases and genetic defects.
How long does it take to find an unrelated donor?
Identifying a donor involves many factors, so the length of a donor search varies. How many possible matches exist, how long it takes to receive samples to confirm typing, and donor availability can all affect the length of a donor search. Our Stem Cell Transplant Patient Coordinator will keep you and your family updated on the status of the search.
What is the cost of typing for donors?
Through Dana-Farber/Children's Hospital Cancer Center, donor typing is free for immediate family members at Dana-Farber Cancer Institute's blood center. Extended family members and friends interested in becoming a marrow donor should contact the National Marrow Donor Program (NMDP), which will provide typing services for a cost of $60. This fee may be covered by the donor's health care insurance plan.
What is the donor process?
A bone marrow donor process begins with a physical evaluation, which includes basic blood tests and screening for infectious disease. If the donor is approved, the donor will have to attend a pre-operative appointment before the bone marrow harvest, a surgical operation to collect the bone marrow.
How long do donors have to stay in the hospital after the bone marrow harvest?
Bone marrow donors stay one night for observation after the bone marrow harvest. If the donor is a child, she will be admitted to the transplantation unit if a bed is available. If the donor is an adult, the harvest and overnight stay occur at Brigham and Women's Hospital.
Can I contact my child's unrelated bone marrow donor?
For the first year after your child's transplant you can have anonymous contact with the donor. Communication is usually facilitated through the National Marrow Donor Program. You may send written correspondence, but no personal information, names or geographical references are allowed. After one year, if both parties agree, you may directly contact the donor.