Treatments and Services
Pediatric Blood and Marrow Transplant Program
What is the Pediatric Blood and Marrow Transplant Program?
Our Pediatric Blood and Marrow Transplant Program provides care for children who need a transplant of blood-forming cells, called hematopoietic (him-at-oh-poy-EH-tik) stem cells. These are young blood cells that can grow into any of the types of blood cells your child’s body needs.
A transplant works by replacing the body's system for making blood cells, including infection-fighting cells needed for a healthy immune system. We do the transplants here at Seattle Children’s, working closely with our partner in the SCCA, Fred Hutch. A transplant may greatly improve or cure several kinds of diseases, including some types of:
Sources of stem cells
Stem cells for transplants may come from the patient or a healthy donor. The patient receives the stem cells through a catheter (tube) into their vein. Cells may be collected from:
- Bone marrow – the soft, center part of bones where blood cells are made
- Blood circulating in the body (peripheral blood stem cells)
- Umbilical cord blood collected after a baby is born (called cord blood)
Allogeneic transplants – using cells from another person
A transplant using stem cells from another person is called allogeneic (AH-loh-jeh-NAY-ik). The new cells replace cells that are abnormal or missing because of disease. Your child may need this type of transplant if they have a disease of their bone marrow or a cancer that starts in their bone marrow, like leukemia. See more about transplants for non-malignant conditions.
The new stem cells may be donated by:
- A sibling or other family member. The transplant has a better chance of success if there is a close match between the cells of the donor and the child getting the transplant. Doctors look for a match of proteins on white blood cells, called human leukocyte antigens (HLA). Siblings are more likely to be a close match.
- A volunteer who is not related but whose cells are a close match.
- Parents of a baby whose umbilical cord blood has been frozen and stored.
Autologous transplants – using a child’s own cells
In some cases, a child receives a transplant of their own stem cells, called autologous (aw-TAH-luh-gus). This type of transplant is given to children whose bone marrow is normal but their cancer treatment is likely to destroy it.
The child’s stem cells are removed before high-dose chemotherapy or radiation. The cells are frozen and stored. After treatment is finished, doctors return the stem cells to your child’s body through a vein. This type of transplant sometimes is called stem cell rescue.
What’s special about the Pediatric Blood and Marrow Transplant Program at Seattle Children’s?
Our dedicated and highly skilled team has many years of experience transplanting children and teens, including very high-risk patients. Our comprehensive program helps your child and family:
- Prepare for a transplant
- Find a stem cell donor, if needed
- Go through each step of the transplant process
- Make the transition back home
- Manage any long-term effects
The Pediatric Blood and Marrow Transplant Program is part of our Cancer and Blood Disorders Center and the Seattle Cancer Care Alliance (SCCA). Please contact the SCCA at 800-804-8824 for more information, to request a second opinion or to make an appointment.
The SCCA is a partnership between Fred Hutch, UW Medicine, and Seattle Children’s. The National Cancer Institute has designated our partnership a comprehensive cancer center. Fred Hutch is one of the largest stem cell transplant centers in the world.
More than 30 years ago, Fred Hutch pioneered stem cell transplants to treat blood disorders in children. Dr. E. Donnall Thomas led the team of scientists and received a Nobel Prize for his groundbreaking work.
For patients with high-risk leukemia, our cancer doctors pair up with the transplant team right from the start. Each patient gets a personalized treatment plan. It includes:
- How to get your child’s disease in remission
- The best kind of transplant for your child
- How to reduce the risk of cancer coming back after transplant
See statistics and outcomes for details on the number of stem cell transplants we do each year and survival rates for children who receive them.
To learn more about our Pediatric Blood and Marrow Transplant Program, visit the pediatric transplant section of the SCCA website.
We aim to make transplant an option for more young people and to make the treatment more successful.
Some patients are too sick to tolerate the powerful drugs or radiation that is usually used to prepare their bodies for the transplant. This preparation is called conditioning. We have developed better ways to prepare them for transplant, called reduced-intensity conditioning. We continue to fine-tune conditioning treatments to improve survival and reduce complications.
As a national research leader, Seattle Children’s can offer our patients treatment options available only through research studies, including Phase 1 clinical trials. These studies of the newest treatments are not offered at most treatment centers. Early in your child’s treatment we work to identify the best clinical trials that can help before or during transplant.
New advances let us transplant patients who previously were not eligible or who would be considered too high risk at other centers. Advanced treatments we offer include:
- A new conditioning treatment using 2 chemotherapy drugs to get the body ready to accept stem cells. Dr. Lauri Burroughs leads the study. Read how results so far show much better survival.
- Better therapies like T-cell immunotherapy that put patients’ cancer into remission so they can receive a transplant.
- New ways to prepare children for transplant if they do not have a fully matched donor. Drs. Lauri Burroughs and Ann Woolfrey lead these studies.
- In some cases, we can use stem cells from donors whose cell types are not a close match, including half-matched (haploidentical) donors.
Seattle Children’s has many years of experience caring for children and teens with conditions that require stem cell transplants.
- Our cancer doctors help set national standards for care of children with cancer.
- For more than a decade, our Cancer Center has been consistently ranked among the top pediatric oncology programs in the country by U.S. News & World Report. For 2019-20, it has the highest ranking in the Northwest.
- Our Immunology Clinic has over 40 years of experience diagnosing and treating children with conditions that affect their immune systems.
- We have experts in treating other body systems that may be affected by your child’s illness, including the heart, lungs, hormones and digestive system.
Transplant may not be the only option for your child’s illness. Our specialists can provide a full range of treatments, based on what is best for your child. These include chemotherapy, radiation therapy, surgery, and immunotherapy.
Our team members work with each other before and during the transplant process so your child gets the very best care for all aspects of their health.
This continues after your child’s transplant. The team follows your child throughout their recovery. This team approach is called multidisciplinary care.
We help kids return to a normal life after transplant, with high quality of life.
One way is helping children avoid graft-versus-host disease (GVHD) after transplant. GVHD happens if the new cells attack the child’s body instead of rebuilding the immune system. Dr. Marie Bleakley works on ways to control T cells from donors so they don’t attack the cells of transplant patients.
Drs. Scott Baker and Eric Chow look for factors that increase transplant survivors’ risk of certain late effects such as high blood pressure, diabetes, obesity and heart disease. Their goal is to find patients at highest risk and reduce their chance of developing these conditions.
We care for your whole child – not just their disease. Your family has a full team behind you. As needed, your child will receive care from specialists in nutrition, pain management, pharmacy, physical therapy, psychology and emotional health. Read more about the supportive care we offer.
At Seattle Children’s, we work with many children and families from around the Northwest and beyond. Whether you live nearby or far away, we can help with financial counseling, schooling, housing, transportation, interpreter services and spiritual care. Read about our services for patients and families.
Conditions We Treat
Your child’s doctors may suggest a stem cell transplant to treat some types of:
- Bone marrow failure disorders
- Immune disorders
- Blood cell disorders that reduce a child’s energy and their ability to fight infection
- Platelet abnormalities, which limit blood clotting and cause bleeding problems
- Inherited metabolic disorders that can make it hard to turn food into energy
- Histiocytic disorders, in which a child’s immune cells damage their body instead of protecting it
- Autoimmune diseases, where a child’s immune system attacks their own body
Who is on the Pediatric Blood and Marrow Transplant team?
Professionals from many fields work together to plan treatment and care for your child. All team members have extra training and years of experience in the special needs of children and adolescents. See the full team at the Cancer and Blood Disorders Center.
Meet our transplant doctors:
- K. Scott Baker, MD, director
- Marie Bleakley, MD
- Lauri M. Burroughs, MD
- Paul A. Carpenter, MD
- Ann Dahlberg, MD
- Brandon Hadland, MD, PhD
- Kanwaldeep K. Mallhi, MD
- Soheil Meshinchi, MD, PhD
- Corinne Summers, MD
- Ann E. Woolfrey, MD