The Bone Marrow Transplant and Cellular Therapy Process

The mission of the St. Jude Transplant Program is to provide excellent patient care for children, teens and young adults with disorders curable by bone marrow /stem cell transplant or cellular therapy, and to advance clinical transplantation research. All patients who undergo transplants or cellular therapy at our institution are treated on clinical trials.

The Transplant Program at St. Jude has been a part of the National Marrow Donor Program (NMDP) since 1990. In addition, our center provides data to the International Bone Marrow Transplant Registry (IBMTR) and Autologous Bone Marrow Transplant Registry (ABMTR) for retrospective trials.

St. Jude treats children, teens, and young adults who have malignant or non-malignant disorders potentially curable by stem cell / bone marrow transplants. Malignant diseases include acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), myelodysplastic syndrome (MDS), chronic myeloid leukemia (CML), non-Hodgkin lymphoma (NHL), Hodgkin lymphoma, germ cell tumors, neuroblastoma, Ewing sarcoma, rhabdomyosarcoma, high-risk brain tumors and other solid tumors. Non-malignant disorders include osteopetrosis, severe aplastic anemia, sickle cell anemia, thalassemia, severe combined immunodeficiency syndrome (SCIDS), Wiskott-Aldrich syndrome, X-linked agammaglobulinemia, X-linked lymphoproliferative disorder, chronic granulomatous disease, and metabolic storage disorders (Hurler syndrome, other mucopolysaccharidoses, Chediak-Higashi syndrome). 

St. Jude was the first institution to perform an allogeneic stem cell / bone marrow transplant in a patient with sickle cell anemia and has conducted pivotal clinical trials in children with osteogenesis imperfecta.

The types of stem cell / bone marrow transplants performed at St. Jude include autologous and allogeneic transplantation.

In autologous transplants, patients receive their own hematopoietic stem cells that have been harvested earlier. Autologous transplant is typically used for patients who have solid tumors or lymphomas that are at high risk of treatment failure. These solid tumors include neuroblastoma, Ewing sarcoma/primitive neuroectodermal tumor (PNET), rhabdomyosarcoma, brain tumors, germ cell tumors, Wilms tumors; non-Hodgkin lymphoma (NHL), and Hodgkin lymphoma. In allogeneic stem cell / bone marrow transplants, the patients receive hematopoietic stem cells from other persons.

Allogeneic stem cell / bone marrow transplant is typically used to treat high-risk leukemias or lymphomas, immunodeficiencies, sickle cell anemia, thalassemia, aplastic anemia and metabolic storage disorders.  New research protocols presently open at our institution are studying allogeneic stem cells donated by mismatched (haploidentical) family members for patients with high-risk hematologic malignancies.

St. Jude is conducting pivotal clinical trials in cellular therapy for leukemia that fails to respond to chemotherapy. Patients receive natural killer (NK) cells donated by their parents. NK cells transplants are performed alone or in combination with bone marrow transplants. Novel NK cell typing techniques are used to select the best NK cell donor. Gene modifications and cell processing research is being conducted to increase the potency of donor NK cells to improve the chance of cure for high risk childhood leukemia.