Pediatrics Hematology/Oncology

The pediatric bone marrow transplant program is a joint venture between the Medical College of Wisconsin (MCW) and Children's Hospital of Wisconsin (CHW). This is the only children's hospital in the state of Wisconsin. The BMT program was initiated in 1980 and shares the protocols and bone marrow purging and processing laboratories with the adult BMT program that is also administered by the Medical College of Wisconsin.

All immunogenetic evaluations, including human leukocyte antigen (HLA) typing and high resolution oligonucleotide typing, are performed at the Blood Center of Southeastern Wisconsin.

Four hundred and seventy-five bone marrow transplants have been performed since 1980. Our current protocol consists of using a standard single antibody T-cell depletion technique (anti CD-3) and a conditioning regimen consisting of total body irradiation, cyclophosphamide, cytosine arabinoside, and methylprednisolone. The Hematology/Oncology transplant (HOT) unit has 32 beds, 16 of which are hepa-filter isolation rooms used for bone marrow transplant patients.

The most common diseases for which bone marrow transplant is utilized include:

• Acute Lymphomatic Leukemia
• Chronic Myelocytic Leukemia
• Immunodeficiency Diseases
• Severe Aplastic Anemia
• Acute Myelocytic Leukema
• Juvenile Chronic Myelocytic Leukemia
• Myelodysplastic Syndromes
• Sickle Cell Disease
   

The primary scientific and clinical focus of the program is the use of unrelated individuals or mismatched family members as donors (235 unrelated donors and 96 mismatched family member donors). Last year, January 1, 1998 through January 1, 1999, 38 BMTs were performed (14 unrelated, 2 related partial match, 12 related matches, 6 haploidentical, 4 peripheral stem cell/autologous marrow transplants).

In 1993 CHW performed its first two related donor transplants for children with sickle cell anemia. Both patients are doing well at six years post BMT.

In May of 1993, we performed our first haploidentical BMT. Donor availability is often times a limiting factor in transplanting patients. A haploidentical BMT utilizes a half-matched family member as the donor. Conditioning consists of our standard regimen with the addition of antithymocyte globulin (ATG). Currently, 12 of the 28 children transplanted with a haploidentical donor are alive.

We have become one of the largest pediatric based transplant programs in the nation by:

• Providing highly qualified staff of professionals who provide a comprehensive approach to children undergoing bone marrow transplantation.
• Publication of our transplant data in medical journals. Click here for a list of our recent publications.
• Continuing education for our BMT team members which will ensure optimal health care delivery to this population of children.
• Maintaining fiscal strength of the program to ensure our continued ability to offer this specialized service to all children who need it.
   

The BMT program is multidisciplinary and includes a broad spectrum of professionals with expertise in children requiring BMT.