Description of service
The Bone Marrow Transplant Unit will be a state-of-the-art 8 bedded unit which performs bone marrow transplants using bone marrow, peripheral blood stem cells or cord blood cells from matched or mismatched related/unrelated donors.
Services provided include assessment for suitability for transplantation, detailed patient and donor work-up investigations, transplantation in HEPA-filtered sterile rooms, immediate post-transplant aftercare (with cellular immunotherapy where required) and detailed long-term follow-up.
Areas of excellence
Transplantation of acute lymphoblastic and myeloid leukaemias, solid tumours requiring autografting, bone marrow failure syndromes (including Fanconi anaemia), adrenoleukodystrophy, metabolic diseases, osteopetrosis and haemophagocytic syndromes (HLH).
There will be a particular expertise in the use of alternative donors including matched and mismatched unrelated donors, haploidentical (half-matched) parents and relatives, and cord blood donors. Detailed surveillance of patients during transplantation will include highly sensitive molecular testing for post-transplant viral infection and detailed, lineage-specific assessment of donor engraftment ("chimaerism").
Conditions to be treated
Acute myeloid leukaemia (in second complete remission after relapse, or with refractory disease)
Acute lymphoblastic leukaemia: high risk disease in first complete remission, relapsed disease in second/third complete remission
Chronic myeloid leukaemia: chronic or advanced phase or blast crisis
T-cell Non-Hodgkin Lymphoma (T-NHL)
Hodgkin's disease in second complete remission
Myelodysplasia (including juvenile myelomonocytic leukaemia [JMML], refractory anaemia, RARS, CMML, RAEBT)
Metabolic diseases (including early-stage adrenoleukodystrophy, fucosidosis, late-onset globoid cell leukodystrophy, a-mannosidosis, juvenile and adult onset metachromatic leukodystrophy, type I and VI mucopolysaccharidoses (Hurler's disease and Maroteaux-Lamy syndrome) and osteopetrosis.
Haemophagocytic syndromes (including HLH, Griscelli disease and Chediak-Higashi syndrome)
Multisystem Langerhans cell histiocytosis (LCH)
Aplastic anaemia and inherited bone marrow failure syndromes (including Fanconi anaemia, Shwachman-Diamond syndrome, dyskeratosis congenita and Diamond-Blackfan anaemia)
Autografts for Neuroblastoma (stage IV disease and stage III disease with n-myc amplification), Atypical Teratoid/Rhabdoid Tumour (ATRT), Primitive neuroectodermal tumour (PNET), medulloblastoma, Ewing's sarcoma, germ cell tumours, rhabdomyosarcoma or Wilms tumour in appropriate high risk, relapsed or refractory disease.