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Paediatric Bone Marrow Transplant

Description of service

The Bone Marrow Transplant Unit at the Bristol Royal Hospital for Children is a state-of-the-art 14 bedded unit which performs bone marrow transplants using bone marrow, peripheral blood stem cells or cord blood cells from matched or mismatched related/unrelated donors. Approximately 40 paediatric auto- and allografts are performed each year.

Areas of Excellence

Transplantation of acute lymphoblastic and myeloid leukaemias, solid tumours requiring autografting, bone marrow failure syndromes (including Fanconi anaemia), adrenoleukodystrophy, metabolic diseases, osteopetrosis and haemophagocytic syndromes (HLH).

There is a particular expertise in the use of alternative donors including matched and mismatched unrelated donors, haploidentical (half-matched) parents and relatives, and cord blood donors. Detailed surveillance of patients during transplantation includes highly sensitive molecular testing for post-transplant viral infection and detailed, lineage-specific assessment of donor engraftment ("chimaerism").

Further Information

Specialist clinics are held both locally and throughout the South-west region. There is a specific long-term follow-up clinic for those who are further out from transplantation. Specific disease clinics also provide advice and general haematological management for acute and chronic leukaemias, bone marrow failure syndromes, adrenoleukodystrophy, Hurler syndrome and metabolic diseases.

There is close liaison with expert geneticists and laboratories providing genetic diagnosis and counselling in many of these areas.

Conditions Treated

  • Acute myeloid leukaemia (in second complete remission after relapse, or with refractory disease)
  • Acute lymphoblastic leukaemia: high risk disease in first complete remission, relapsed disease in second/third complete remission
  • Chronic myeloid leukaemia: chronic or advanced phase or blast crisis
  • T-cell Non-Hodgkin Lymphoma (T-NHL)
  • Hodgkin's disease in second complete remission
  • Myelodysplasia (including juvenile myelomonocytic leukaemia [JMML], refractory anaemia, RARS, CMML, RAEBT)
  • Metabolic diseases (including early-stage adrenoleukodystrophy, fucosidosis, late-onset globoid cell leukodystrophy, a-mannosidosis, juvenile and adult onset metachromatic leukodystrophy, type I and VI mucopolysaccharidoses (Hurler's disease and Maroteaux-Lamy syndrome) and osteopetrosis.
  • Haemophagocytic syndromes (including HLH, Griscelli disease and Chediak-Higashi syndrome)
  • Multisystem Langerhans cell histiocytosis (LCH)
  • Thalassaemia major
  • Sickle cell anaemia
  • Aplastic anaemia and inherited bone marrow failure syndromes (including Fanconi anaemia, Shwachman-Diamond syndrome, dyskeratosis congenita and Diamond-Blackfan anaemia)
  • Autografts for Neuroblastoma (stage IV disease and stage III disease with n-myc amplification), Atypical Teratoid/Rhabdoid Tumour (ATRT), Primitive neuroectodermal tumour (PNET), medulloblastoma, Ewing's sarcoma, germ cell tumours, rhabdomyosarcoma or Wilms tumour in appropriate high risk, relapsed or refractory disease

Treatments Offered

The unit has an international reputation for its pioneering work in transplantation for those lacking matched family donors, with 20 years experience in this area. Services provided include assessment for suitability for transplantation, detailed patient and donor work-up investigations, transplantation in HEPA-filtered sterile rooms, immediate post-transplant aftercare (with cellular immunotherapy where required) and detailed long-term follow-up.

General Contact Details

Lucy Henderson
Adult BMT Nurse Co-ordinator/Clinical Nurse Specialist
Tel: 0117 342 8142
Fax: 0117 342 8648
Email: Lucy.Henderson@UHBristol.nhs.uk

Charlotte Nicol
Paediatric BMT Nurse co-ordinator/CLinical Nurse Specialist
Tel: 0117 342 8077
Mobile:  0771 770 1669
Email: Charlotte.Nicol@UHBristol.nhs.uk

Oncology Day Beds
Level 6
Bristol Royal Hospital for Children
Upper Mudlin Street
Bristol BS2 8BJ 

Patient information leaflets

Patients being admitted for a Bone Marrow Transplant may find the following leaflets useful:

  • Bone Marrow Transplant Unit
  • Busulfan
  • Caring for your teeth after chemotherapy and/or radiotherapy involving the jaws
  • Cyclophosphamide
  • Cytarabine
  • Etoposide
  • Fludarabine
  • General care during radiotherapy
  • Holistic massage at the Bristol Royal Hospital for Children for Oncology and Haematology patients on BMT/Oncology Day Beds/Wards 34/35
  • Holistic Massage on the BMT Unit and Oncology Wards
  • Ifosfamide
  • Melphalan
  • Methotrexate
  • Steroids
  • Your Story

The above can all be accessed via the following link: http://nww.avon.nhs.uk/dms/Default.aspx?sid=0&s2id=108

  • Your Child's General Anaesthetic

Can be accessed via the following link: http://nww.avon.nhs.uk/dms/Default.aspx?sid=0&s2id=100

  • Friends for parents
  • Looking for information: The family information room
  • Parking at Bristol Royal Hospital for Children
  • Spiritual healthcare at Bristol Royal Hospital for Children
  • Terms and Conditions of your parking permit

Can be accessed via the following link: http://nww.avon.nhs.uk/dms/Default.aspx?sid=0&s2id=110

  • Play department
  • The story of Charlie and Freddie the nasogastric feeding tube

Can be accessed via the following link: http://nww.avon.nhs.uk/dms/Default.aspx?sid=0&s2id=48

  • Having a CT scan at the Bristol Royal Hospital for Children

Can be accessed via the following link: http://nww.avon.nhs.uk/dms/Default.aspx?sid=0&s2id=160