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FAQs About Pediatric Blood and Marrow Transplant

How long before the BMT starts working?

Engraftment of the stem cells occurs when the donated cells make their way to the marrow and begin producing new blood cells. Depending on the type of transplant and the disease being treated, engraftment usually occurs between day +15 and +30.

Engraftment can be delayed because of infection, medications, low donated stem cell count, or graft failure. Although the new bone marrow may begin making cells in the first 30 days following transplant, it may take months, even years, for the entire immune system to fully recover.

How do the doctor’s know if engraftment of the stem cells has occurred?

Blood counts will be performed frequently during the days following transplant to evaluate initiation and progress of engraftment. Platelets are generally the last blood cell to recover.

When will my child be discharged?

The timing of your child’s discharge following BMT depends on many factors, including the extent of engraftment, presence of complications, your child’s overall health, and your home’s distance from Phoenix Children’s.

What kind of follow-up care is required after bone marrow transplantation?

Frequent visits to your child's transplant team will be required after discharge to determine effectiveness of treatment, detect complications, detect recurrent disease, and to manage the late effects associated with a bone marrow transplant. Your child’s transplant team will determine the frequency and duration of the follow-up visits.

What is the long-term outlook for bone marrow transplant recipients?

As with any procedure, prognosis and long-term survival varies for each patient. The number of transplants being done for an increased number of diseases has greatly improved the outcome for BMT recipients. Continuous follow-up care is essential for the child, while new methods to improve treatment and decrease complications and side effects of a transplant are continually being discovered.

Are we able to learn the identity of our child’s matched unrelated donor?

If the donor is not a relative you will not be able to immediately learn their identity or other details about them for confidentiality reasons. However, the donor’s identity can be disclosed if both you and the donor agree, and more than a year has passed after the transplant.

How much pain will the donor experience?

It is important to remember that the donor is helping the patient by donating their bone marrow, but also undergoing a very specialized procedure that requires general anesthesia or multiple medication injections. These procedures may result in some mild discomfort for the donor for a few days. The donor may spend a night at the hospital after the collection, or they may be able to go home a few hours after the procedure.

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