Bone marrow transplant

Bone marrow is soft tissue that lives in the cavities of some bones and is the source of all blood cells.

If you have a bone marrow transplant (BMT) at Great Ormond Street Hospital (GOSH) it replaces cells in bone marrow and swaps them for new cells. These might be your own cells, or cells from a related or unrelated donor.

A BMT is given when there is something wrong with your blood cells. This might be because you have a condition like leukaemia, lymphoma or another type of cancer.

Or it could be because you are anaemic or have a genetic disease. It can also be because you have cancer that is in remission but is likely to come back.

You will have a few tests before your transplant, such as a heart scan and dental and hearing checks. You will also have a chest x-ray and breathing and exercise tests.

Before you start treatment you will also have a tube called a ‘central line’ put in your chest. This is so that you can be given fluid and medication easily, blood samples can also be taken from this line, reducing the need for needles. The central line will be put in under a general anaesthetic.

Shortly after this, you will receive chemotherapy and possibly radiotherapy to prepare your body for the new marrow.

You can expect to be in hospital for around two months. You’ll have a room of your own which will protect you from any infections – this is referred to as being in ‘isolation’. This room will have a TV, radio and your own bathroom. You won’t be able to see friends but you can chat to them on the phone or on email. This is so they don’t bring any germs in which could put you at risk of infection. A parent can be with you while you have treatment though.

It can take two or three weeks for the new marrow to start to grow. When this starts to work you’ll be allowed more visitors and can start leaving your room.

When the amount of new blood cells increase and you are starting to get your appetite back, you can think about going home. But there are things you will need to be careful about. You may have to avoid certain things for a while because they could put you at risk of infection. Things like:

• buses, trains and busy areas with large groups of people
• certain foods (you will be given a list)
• water that hasn’t been boiled
• people who are sick or unwell 

You can go out in the fresh air though, or visit the park and other open spaces if you feel up to it. You will be told about problems to look out for – like a fever, for example. You’ll also have to go back to clinic about once a week to check that everything is going well and to have blood tests.

You won’t be able to go back to school or college for about six months, but a teacher or tutor can come to your house. When you are well enough to go back you can do this gradually, just for a few hours or half a day. When you don’t need any more blood tests or medicine you can have your central line removed.