At OHSU Doernbecher, you’ll find exceptional expertise in bone marrow/stem cell transplant and a team that treats your child with compassion at every step. We are the only program in Oregon to offer transplants for children.

We offer:

• Doctors who are international experts in bone marrow/stem cell transplant
• A deeply experienced team that has done over 4,500 transplants, including over 700 in children.
• A state-of-the-art transplant facility with HEPA filtration to block germs and lower infection risk
• Survival rates among the best in the nation. Our transplant program earned an “excellent” rating from U.S. News & World Report.
• A caring staff of doctors, advanced practice providers, nurses, dietitians, social workers and other specialists and an environment built just for children
• Housing support for patients and families who live outside the Portland area
• Doctors and scientists who are part of the OHSU Knight Cancer Institute and working to devise new therapies
• Access to national clinical trials to test promising new treatments

What is a bone marrow/stem cell transplant?

Bone marrow is the soft, spongy material inside bones that contains stem cells. Stem cells produce blood cells for our bodies.

Stem cells grow and mature into:

• White blood cells that fight infection
• Red blood cells that carry oxygen throughout the body
• Platelets that help the blood clot

A bone marrow transplant replaces unhealthy stem cells with new healthy stem cells to treat cancer or noncancerous blood disorders. The healthy new cells may come from different sources:

• Bone marrow transplant: The healthy stems cells come directly from the bone marrow of a donor.
• Peripheral blood stem cell transplant: Stem cells move from the bone marrow into the bloodstream and are collected from blood.
• Umbilical cord blood transplant: Stem cells are collected from the umbilical cord blood and placenta after babies are born.

Types of bone marrow/stem cell transplants

One type of transplant uses your child’s own cells. The other uses donated cells from another person. Each type has risks and benefits.

Autologous transplant uses your child’s own stem cells. This eliminates the risk of your child’s body rejecting the cells or of cells attacking their body.

In this type of transplant, stem cells in your child's blood are removed and frozen. After intensive chemotherapy that kills most of your child’s normal bone marrow cells, the stored stem cells are returned to your child's bloodstream in an IV drip.

The transplanted stem cells grow into normal bone marrow cells.

Autologous transplants can treat neuroblastoma and some types of brain tumors.

Allogeneic transplant uses stem cells from a donor. We choose the best donor available, based on a close genetic match with your child. Donor cells may also come from cord blood.

Donor cells are very good at killing diseased cells. But they may also target your child’s healthy cells, or your child’s body may reject donor cells.

Allogeneic transplants can treat many types of cancer and non-cancerous blood disorders.

Conditions we treat with bone marrow/stem cell transplants

We treat many types of cancer and noncancerous conditions with transplants.

Cancers we treat:

• Leukemia
• Lymphoma
• Myelodysplastic syndromes
• Neuroblastoma
• Brain tumors

Noncancerous blood disorders we treat:

• Sickle cell disease and other hemoglobin diseases
• Immunodeficiencies
• Fanconi anemia and other bone marrow failure syndromes
• Inborn errors of metabolism

How bone marrow/stem cell transplant treatment works

If tests show a transplant could help your child, we’ll begin the transplant process. The transplant is like a blood transfusion. However, treatments that happen before the transplant, like chemotherapy, can be difficult. Our doctors, nurses, social workers and other experts work together to support your child and family.

Your child will be in the hospital for about a month. We will closely monitor your child to watch for infections and other issues.

First appointment and evaluation

We will talk with you about your child’s medical history and whether they would benefit from a transplant.

The first meeting will include your child's transplant doctor, a nurse coordinator to help your family through the process and a social worker to support your family. We’ll also start the process of insurance authorization.

Evaluation: After the first meeting, your child will have tests to help us better understand if a transplant is the best option.

If we plan to use your child’s own stem cells, we’ll collect them from your child’s blood. We will freeze the cells and store them until it is time for the transplant.

If we are using donor cells, we will find the best available matching donor. Donors usually donate their stem cells close to when they will be given to your child.

Stem cells from cord blood are already frozen and stored. We will have them shipped to use right before the transplant.

Transplant

Once a transplant type and donor are chosen, we will admit your child to the hospital. Over the next few weeks, they will get chemotherapy, radiation therapy or both, depending on their condition.

This treatment helps your child’s body prepare for a transplant. It destroys cancer cells and prepares their immune system to receive the new stem cells.

The new stem cells are placed in your child’s bloodstream through a central venous catheter (a thin, flexible tube we place in a large vein on the neck, chest or arm). After a few weeks, they start to produce new blood cells.

Recovery and rehabilitation

Transplants can be physically and emotionally challenging. Our whole team is here to support your child and family.

Your child will usually stay in our transplant unit for about a month before, during and after the transplant.

Our unit is designed with children’s safety and comfort in mind. It has HEPA filtration to reduce germs and the risk of infection.

Once your child leaves the hospital, we will see them regularly for several months. We will monitor their recovery and look for any signs of problems with the transplant.

It is very important to stay nearby in the first few months after your child’s transplant. If you live more than one hour outside the Portland area, you and your child will need to stay close to the hospital. Our team can help you find a place to stay, such as OHSU’s Rood Family Pavillion.