What Are the Dangers of Bone Marrow Transplant in Children With CML?

Chronic myelogenous leukemia, or CML, is a slow-growing form of blood cancer. According to the National Marrow Donor Program, most of the 20,000 people in the United States who have it are adults, but 2 to 4 percent of patients are children. A bone marrow transplant is one possible treatment, but it can be dangerous to children who undergo the procedure.

CML

• CML is a relatively common form of leukemia. It is caused by a genetic abnormality in a child's bone marrow. The abnormality signals the bone marrow to produce too many white blood cells. These white blood cells do not perform well and soon crowd out healthy platelets and red blood cells, says the Children's Hospital Boston website. This leads to the symptoms of CML, including infection, anemia and abnormal bleeding.

The Facts

• Once a compatible donor has been found, a bone marrow transplant can be performed. Bone marrow is first harvested from a donor. The child with CML will be given a high dose of chemotherapy or radiation to destroy cancer cells and the damaged marrow, reports the National Cancer Institute. After that, the bone marrow is introduced into her body through an IV line. The bone marrow cells travel through her blood stream to her bone marrow, where they begin to produce new platelets and red and white blood cells.

Dangers

• Dangers of a bone marrow transplant in children with CML can be short and long term. Short-term dangers include the risk of developing an infection, anemia or uncontrolled bleeding. A child could also lose his hair, experience nausea or develop skin problems. He could also develop graft-versus-host disease, which occurs when his body rejects the new marrow cells. Long term, he will be at risk for cataracts, fertility problems and damage to his heart, lungs or kidneys, reports the National Cancer Institute.

Treatments

• Doctors try to reduce the dangers children with CML will face after a bone marrow transplant. Carefully matching a bone marrow donor to the child will reduced the risk of developing graft-versus-host disease. Keeping a child isolated and giving her antibiotics before and after the transplant can prevent infection. Transfusions of red blood cells can prevent anemia, says the National Cancer Institute, and long-term dangers like cataracts can be corrected with surgery.

Considerations

• There is no guarantee that a bone marrow transplant will work. Other treatments for CML in children can be tried first, such as drug therapies, which present fewer dangers to the patient. If the first drug does not work, then a different drug is often the next step in treatment. A bone marrow transplant is usually attempted when other options have failed to work.