CareTalk Blog: Nemours Center for Cancer and Blood Disorders

CareTalk: Blog for Cancer and Blood Disorders

Get insights and inspiration from Nemours’ experts in Hematology/Oncology.

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Blood & Bone Marrow Transplant

Through the Nemours Center for Cancer and Blood Disorders (NCCBD), our pediatric blood and bone marrow transplant specialists offer families the hope of a potential cure for a wide range of diseases, including cancers (like leukemia, lymphoma, and solid tumors), blood disorders, immune system diseases, and many inherited genetic diseases and bone marrow failure syndromes.

 
About Blood and Bone Marrow Transplants in Children

A blood and bone marrow transplant replaces diseased or damaged cells
in children whose normal blood cells either aren’t working correctly or have been crowded out by abnormal cells. These damaged or diseased cells are immature cells that can develop into healthy blood cells in children after a transplant.

Nemours/Alfred I. duPont Hospital for Children, Wilmington


1600 Rockland Road
Wilmington, DE 19803
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For Appointments: (302) 651-4200

U.S.News & World Report Best Children’s Hospitals: Cancer
 
What to Bring
  • photo ID
  • medical and pharmacy insurance cards
  • preferred pharmacy name and phone number
  • names and dosage of all medications, including over-the-counter medication, your child is currently taking
  • guardianship and custody papers, if a legal guardian rather than a parent accompanies your child
New Patients

Bring these forms for your first appointment:

Returning Patients
Blood & Bone Marrow Transplant Form
  • Patient Treatment Summary (PDF)
 
Forms & Resources
New Patient Forms
Returning Patient Forms
Resources for Patients & Families
Support Services
 
Camps for Children with Blood Disorders and Cancer

Hole in the Wall Gang Camp: Founded by Paul Newman, and located in Ashford, CT, this year-round free camp is open to children with cancer or blood disorders between the ages of 7 and 15 and their siblings. 

Camp Sunshine: Located in South Casco, ME, this free camp for families is designed to provide respite, professional counseling, and recreational opportunities to families facing the physical, emotional, and financial strain of a child with a critical illness. 


When your child needs a blood or bone marrow transplant, you want to make sure you’re getting the best possible care. At the Nemours Center for Cancer and Blood Disorders (NCCBD), we understand — and we can help. Our board-certified pediatric hematologists-oncologists and others on our pediatric blood and bone marrow transplant team have years of experience and advanced training in helping children with blood and bone marrow disorders get top-quality care.

Children who need a pediatric blood or bone marrow transplant (also sometimes called BBMT, BMT, stem cell transplant, or cord blood transplant) require specialized care. Our pediatric hematologists-oncologists are here to help children and teens with blood disorders including bone marrow failure, sickle cell disease, anemias, and other types of cancers.

Not only does our center allow us to enhance our care and treatment of your child, but it gives our specialists across all Nemours locations the opportunity to collaborate on important research — to give your child the very best, most informed care.

 
Types of Conditions We Treat
Some of the conditions we commonly treat with a blood or bone marrow transplant include (but are not limited to):
  • sickle cell disease: a common inherited disorder in which an abnormal hemoglobin gene causes red blood cells to become sticky, blocking the small blood vessels
  • thalassemia (Cooley’s anemia): a genetic condition in which one of the two proteins that help makeup hemoglobin in red blood cells is lacking
  • leukemias: cancers that affect the white blood cells
  • solid tumors: like neuroblastoma
  • bone marrow failures: including severe aplastic anemia, hemophagocytic lymphohistiocytosis (HLH)
  • lymphoma: including Hodgkin’s disease and non-Hodgkin’s
  • immunodeficiency diseases
  • other rare disorders in which a pediatric bone marrow transplant is a treatment option
 
Your Child's Pediatric Bone Marrow Transplant Team
When your child is referred to us for a bone marrow transplant, you and your child will interact with several members of our team including:
  • pediatric transplant physicians: doctors who care for children getting stem cell transplants
  • pediatric hematologists/oncologists: doctors who treat children with blood disorders and cancers
  • pediatric radiation oncologists: doctors specially trained in radiation therapy
  • transplant coordinator: who helps you navigate services and treatments throughout the entire process
  • nurses with expert training in caring for children with all types of cancers, blood and bone disorders, and bone marrow transplant
  • licensed clinical social worker: who’s involved from the first visit and who will help you and your child prepare for the inpatient stay as well as a provide assistance with other resources including financial support
  • blood bank personnel
  • registered dietitian: to help with nutritional health throughout the transplant process
  • psychosocial counselors: to evaluate your child and offer interventions throughout treatment
  • therapy services such as physical, occupational, and speech therapy, to help maximize strength, conditioning, and rehabilitation
  • child life specialists: who assist with the psychosocial and emotional needs of your child, provide supportive and educational services, and offer positive coping strategies using art and music therapy to help your child understand and deal with the entire hospital experience
  • music therapists, art therapists, and Healing Touch practitioners
  • palliative care and symptom management
 
Onsite Services and Amenities for Your Child and Your Family

At the duPont Hospital for Children, we want to make the pediatric bone marrow transplant experience as stress-free as possible for you and your child. That’s why part of our top-rated care include amenities and conveniences right here at the hospital such as:

  • free valet parking
  • on-site pharmacy
  • playground for children recovering from a transplant
  • cafeteria and café
  • gift shop
  • Child Life Activity Center, in addition to bedside activities provided by child life specialists
  • kid-friendly play areas designated for children who received a transplant
  • physical and occupational therapy, designed for children who received a transplant
  • exercise equipment for children and their families on the transplant unit
  • non-denominational chapel
  • Family Resource Center & Ronald McDonald Room: This area was created — with families like yours in mind — with the help of our friends at the Ronald McDonald House to provide you with some of the comforts of home:
    • laundry facilities
    • showers
    • kitchenettes
    • library for reading materials and DVDs
    • business center including a copier, fax machine, computers and printers
    • three sleep rooms, each containing a full-sized bed
We also offer the following family-centered services:

Pediatric Oncology Day Therapy: Children with blood disorders and cancer who don’t need to be admitted to the hospital can receive outpatient care for testing including:   

  • assessment
  • chemotherapy administration
  • pheresis (a special type of blood donation)
  • blood transfusions
  • minor procedures
  • patient and caregiver education 
  • nursing care

Integrative Medicine: We treat not just your child’s condition, but your child’s and your family’s feelings and spirit, too. That’s why our Integrative Medicine services work in conjunction with your child’s medical care, blending traditional and alternative/complimentary/holistic medical therapies to help reduce pain and anxiety, and help kids feel better physically and emotionally.

Some of our offerings include:  
  • Healing Touch, a therapeutic service offered to all children and their families that uses both touch and non-touch methods to promote relaxation and relief from clinical services and procedures
  • massage therapy
  • pet therapy
  • art therapy
  • aromatherapy
  • music therapy
  • mind-body meditation
  • yoga

Onsite school: To make sure your child doesn’t fall behind in school, our onsite school is staffed by professional teachers who will come to your child’s room for instruction. Our teachers also will work with your child’s regular school teachers to develop a personalized education plan. When your child returns home, your transplant coordinator and your child’s teacher will work together to arrange a smooth transition of school services.

GetWellNetwork educational programs: While your child is staying in the hospital, you can watch informative cancer or sickle cell disease videos (right at your child’s bedside). Produced by Nemours’ own KidsHealth.org, the #1 most-visited website in the world for children’s health. and the GetWellNetwork Inc., these videos help you, your child, and your whole family understand what to expect from your child’s condition, treatment and beyond.

KINFolk: This organization helps fight boredom, isolation, and depression associated with hospital admissions and visits. With the use of laptops, iPads, and other technology, chronically ill children (both inpatients and outpatients) stay mentally stimulated and in-touch with their support network. 

Weekly town-hall-style meetings: In order to improve our care, we invite parents of children receiving inpatient treatment to weekly meetings. These meetings were designed to address concerns and answer questions that may come up from living in a communal or hospital-based environment.

Family Advisory Council: Based on their own experiences, parents of children receiving treatment for a blood disorder or cancer serve on this advisory council. From child-friendly décor to functionality, these parents help us make your child’s entire hospital experience less stressful such as: mini-refrigerators in your child’s hospital room, to better access to social workers, prayer groups, and more.

Thomas P. Ferry Program for Palliative and Supportive Care: This in-hospital program is designed for children with serious or complex medical illnesses and their families. The program is focused on relieving pain and making children with cancer comfortable.

 
How Does a Blood or Bone Marrow Transplant Work?

A blood or bone marrow transplant replaces abnormal or unhealthy cells with healthy ones.

Healthy stem cells are found in:
  • bone marrow: the spongy tissue inside of bones
  • blood circulating in your child’s body: also known as peripheral blood
  • umbilical cord blood: donated by a mother after the birth of a baby
There are two main types of stem cell transplants:
  • autologous, which uses your child’s own cells
  • allogeneic, which uses new bone marrow stem cells from an unrelated donor, a close relative or cord blood
The procedure of harvesting stem cells (which is similar to having a blood transfusion) is divided into two steps: 
  • Your child’s blood levels are monitored for about a week to make sure your child is ready to be admitted to the hospital to start harvesting stem cells.
  • Once your child is given the OK to be admitted to the hospital, our experts will start the procedure, which can last from 1-4 days.
 
Before Your Child’s Pediatric Bone Marrow Transplant Procedure

Before your child’s transplant, we’ll get a complete medical history and do a physical examination to determine your child’s condition and availability of a matching donor. Then we’ll design a treatment plan especially for your child.

 
During Your Child’s Pediatric Bone Marrow Transplant Procedure

Before the transplant, your child will receive conditioning therapy. On the day of your child’s transplant, the blood, marrow, or cord blood is given through an intravenous (IV) line. Often this procedure is well-tolerated and your child can continue to watch TV, play games, or work with child life specialists.

Your child will remain in the hospital until the new cells that were just infused through the IV have created enough healthy cells on their own. During this time, we’ll monitor your child closely by taking protective measures to reduce the risk of infection during this recovery time.

Also during your child’s hospital stay, our transplant coordinator will meet with you and your child for post-transplant education to make sure your child has the best chance for a successful recovery.

Some of the information discussed may include:
  • home nursing care
  • easing back into normal activities
  • long-term care guidelines 
 
After Your Child’s Pediatric Bone Marrow Transplant Procedure

A few weeks following your child’s bone marrow transplant procedure, healthy stem cells begin to grow in your child’s bone marrow. During this time, your child will remain in the hospital for about 30 days and will be closely monitored for the risk of infection.

It may take six months or more for your child to recover and feel strong enough to resume normal activities like attending school.

 
General Health Guidelines Following a Pediatric Bone Marrow Transplant

Until your child has been cleared by our pediatric transplant doctor and before being able to return to school and normal activities, try to follow these general health guidelines:              

  • Avoid crowds: shopping centers, grocery stores, restaurants, parties, etc.
  • Avoid contact with people who are or were recently ill. Even though your child won’t be required to wear a mask, it’s a good idea to screen all visitors.
  • Practice good hand-washing.
  • Practice good dental hygiene.
  • Bathe your child daily with regular soap and water.
  • Avoid physical contact sports like weight lifting, football, skating/rollerblading.
 
We Value Your Involvement in Your Child’s Care

We may know how to treat your child’s condition, but no one knows your child better than you. That’s why we want you to be an active participant in the decision-making process for your child’s treatment. We’ll explain every step in easily understandable terms, present all options including alternative methods, and invite your input.

Whatever you’re facing, know that at Nemours, we do whatever it takes to give your child the very best, most compassionate treatment possible. We treat every child as we would our own — your child, our promise.