Is Bone marrow transplant suitable for children?

Surgical Instruments

Consider the following story

Prashant was a happy, but a weak kid. To that end, he could not play around all day, couldn’t study a whole lot. However, he was still happy. Why? Because his family was always by his side at all times. One day, he got a cut in his hand and he just couldn’t stop bleeding for a few minutes. The cut wasn’t even that deep. After his family took him to the doctors they found out that that he has leukaemia. At that point his father asked-‘What sort of Luekaemia?’ and the doctor responded with telling him about the AML. When asked for treatment options, the doctor told him about chemotherapy and Bone marrow transplant is the only viable form of treatment for this particular disease, the doctor replied with the option of BMT. Hearing that, Prashant’s father forehead told every worry that he has in his mind.

The above story is purely fictional, but based on absolutely true events. Why was Prashant’s father worried when he heard about the treatment? This is the question to be answered here. Well, for one, Prashant is supposed to be 9 years old and BMT or Bone Marrow Transplant is one of the penultimate procedures for blood disorder. To that end, there has been a debate upon the matters of side effect of  bone marrow transplant in children, and this talk of side effects have progressed even further to the matters of suitability and success rate in children.

What is Bone marrow transplant?

Before we ponder about the suitability of the process in children, let us first dive into the matter of definition of what is Bone marrow transplant-

Bone Marrow transplant is an intricate procedure where to deal with the certain types of blood and certain types of neurological disorders, stem cells are grafter in the bone marrow. Doing so, it is tried that the new cells that are produced are not abnormal ones, but healthy ones.

This particular form of procedure is considered to the last ditch effort to treat blood cancer and similar conditions. There are two ways by this form of procedure is conducted:

  1. Autologous: Autologous transplantation is the one where the stem cells are taken from the body of the patient himself.
  2. Allogeneic: In this form of transplantation, there is another person who is the donor of the stem cells.

This was a succinct description of what Stem cell transplant or BMT is. To recap:

  1. BMT means transplanting the blood forming stem cells in the bone marrow.
  2. The new blood cells that are produced are expected to remove the abnormal cells of the patient.
  3. The donor of the stem cells can either be another donor or the patient himself.

Why was Prashant’s father so worried?

While the Bone Marrow transplant is known to one of the most advanced procedures, it has an intensive recovery regime and there are side effects associated with it that can make any concerned parent think twice about the process, and this was the reason that Prashant’s father was worried. The side effects and the complications of the transplantation include:

  1. The matter of infection: if there is one thing to remember, it is that the immune system can get compromised if the bone marrow is not producing enough amounts of white blood cells.
  2. The platelets and the red blood cells are at low levels: The low platelet amount can cause excessive bleeding and low red blood cells cause weakness. Combined, these can be even life threatening.
  3. Diarrhea:  Chemotherapy is done prior to Bone marrow transplant to control the amount of blasts in the blood. The chemicals introduced intravenously during this process can cause symptoms akin to diarrhea, nausea and vomiting.
  4. Over load of fluids: This is a circumstance where the kidneys are not able to keep up the amount of fluids in the body. This is to be expected as therapy can leave the body in quite a weak condition.
  5. Damage to the organs: This is one complication that makes everyone think twice before opting for BMT. This happens if the infection that we discussed in the very first point is not properly heeded to and eventually the organs like the heart and liver might fail.
  6. Organ v/s the host: A child’s internal faculties are not as strong as one might hope. To that end, the immune system of their body can treat the foreign graft as an infection and this make the immune system to attack the part.
  7. Pain: Pain is a common side effect of BMT and while it can be managed by the aid of medication, it can be pretty excruciating for a child.
  8. The grafted cells might just fail: we can say all we can about the intricacies and amazing advances of Bone marrow transplant, but the truth is that it is not immune to failure. This is one complication that can happen if no heed is taken to the infection or the immunosuppressant are not working properly.

The above side effects and complications can deter any concerned parent from taking a treatment that has proven to be of a high enough success rates of 62 %. However, the side effects can in fact be managed and as for the complications, well, the cases of this are there, but they are few.

Is the procedure suitable for children?

Well, as far as the survival rate of the procedure in children goes, it lies between 69.1 % and 87.5 %. With such a high success rate, it would be foolish not to take an interest in this procedure. However, if we take the suitability of this measure in children, yes the procedure is suitable for children due to the following reason:

  1. It has been proven to be a successful procedure for children.
  2. The side effects can be dealt using medications and life style changes.
  3. The complete cell recovery process after the procedure is complete is about 2 to 3 weeks.

So here is your answer, yes the process is rather suitable for children. Al though, the recovery process would also require some care from parent as well, but your child would pull through the process.