Pediatric Blood and Bone Marrow Transplant 

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The Blood and Marrow Transplantation Program of Mayo Clinic Florida, Nemours Children’s Specialty Care, Jacksonville, and Wolfson Children's Hospital is a unique, collaborative effort between three renowned organizations. This allows for greater collaboration in physician and staff expertise, research and clinical protocols, which ensures the best possible care for all patients. 

Mayo Clinic maintains the program's adult transplant unit and cryopreservation laboratory, Nemours Children’s Specialty Care, Jacksonville, provides pre-transplant and post transplant care, and Wolfson Children's Hospital maintains the pediatric transplant unit.

Previously known as a bone marrow or stem cell transplant, a hematopoietic progenitor cell (HPC) transplant replaces defective or damaged cells in patients whose normal blood cells have been crowded out by cancerous cells. Transplants can also be used to treat hereditary disorders of the immune system and red blood cell production.

Our pediatric transplantation program is the site of great promise for treatment of a number of childhood diseases including, but not limited to the following:

  • Aplastic anemia
  • Brain tumors
  • Ewing's sarcoma
  • Hodgkin's disease
  • Leukemia
  • Neuroblastoma
  • Non-Hodgkin's lymphoma
  • Sickle cell anemia
  • Solid tumors

The following types of HPC transplants are performed at our center:

Autologous - replacement cells are taken from the patients themselves before chemotherapy and then replaced after treatment

Allogeneic - replacement cells come from a donor whose tissue closely matches the patient (either from a sibling, an unrelated adult donor, or umbilical cord blood)
  
Each patient who is referred to our program will meet with one of our transplant physicians, the transplant coordinator and other members of our transplant team to determine if a transplant is the best possible treatment for his or her condition. Each treatment plan is individualized, based on each patient's medical history and overall condition.

The transplant procedure begins with either securing hematopoietic progenitor cells from one's own blood or marrow or finding a suitable, healthy HLA-matched donor to provide cells. If the progenitor cells are obtained from the marrow, the transplant is often referred to as a bone marrow transplant. If the stem cells are obtained from the blood, the transplant is referred to as either a peripheral blood or an apheresis transplant.

Treatment begins with chemotherapy, with or without radiation. This is called conditioning.  It is designed to treat the patient's disease.  If the cells are coming from a donor, this treatment also prepares the patient's immune system to accept the donor's cells. Conditioning will destroy or damage both abnormal and normal cells. That is why, after conditioning, the patient is given an infusion of healthy progenitor cells.

Following the transplant, the progenitor cells grow in the patient's bone marrow and generate healthy, cancer-free marrow and blood cells. Prior to recovery of the marrow, patients are at risk for developing infections, bleeding, and anemia. During this time patients may need transfusions of red cells and platelets until their marrow can produce these on its own. Patients will remain in the hospital from the conditioning phase until after their marrow has completely recovered.  Once the patient is discharged from the hospital, he or she will have frequent visits at Nemours Children’s Specialty Care, Jacksonville, and/or their referring clinic to monitor their progress for months after transplant. 

A blood or marrow transplant is a team effort, with the patient and their primary caregiver being the most important members of the team. Our hospital and clinic team members include physicians, a transplant coordinator, nurses, social workers, child life specialists, psychologists,  pharmacists, physical therapists, laboratory staff, dietitians, chaplains and volunteers who all work together to make each transplant successful.

Our program has been awarded national accreditation by the Foundation for Accreditation of Cellular Therapy (FACT) and is recognized by the National Marrow Donor Program (NMDP) as an affiliated center for matched unrelated donor transplants. 

For more information about our transplant program, please contact the appropriate person listed below.

Annette Dukes, RN, BSN, MBA/HCM, CPON
Pediatric Transplant Coordinator
Phone: 904.697.3992
Fax: 904.697.3858
adukes@nemours.org

Blood and Marrow Transplantation Program of Mayo Clinic,  Nemours Children’s Specialty Care, Jacksonville, and Wolfson Children's Hospital
NMDP Transplant Center #316
807 Children's Way
Jacksonville, FL 32207

 
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