Bone Marrow Transplant Unit

The establishment of the Bone Marrow Transplant Unit at the CCHE, the largest pediatric oncology hospital in the world, was not an option but a must if we are to always strive to provide standard quality care to our patients. Bone Marrow Transplant is a therapy for children with cancer or other diseases that affect their bone marrow. It is the treatment of preference for a large number of diseases of the immune and blood systems such as acute and chronic leukemia, lymphomas; immunologic and hematologic disorders. It has also been used to successfully treat a variety of childhood solid tumors, including Neuroblastoma, Wilms tumors and Extraocular Retinoblastoma. The goal of a Bone Marrow Transplant is to transfuse healthy bone marrow cells into your child after unhealthy bone marrow has been destroyed.

The Bone Marrow Transplant unit which is composed of 9 beds was launched in November 2009 and performed only autologous bone marrow transplant. Autologous means stem cells are taken from the patient himself. The cells are gathered, preserved and frozen when chemotherapy or radiation is done, the patient gets their stem cells back. In 2012, the unit started performing allogeneic transplants. In this case, stem cells come from another matched donor either from bone marrow or from peripheral blood source. A patient’s brothers and sisters have the highest chance of being a good match. Other alternative stem cell sources can be obtained from umbilical cord but is now largely replaced by haploidentical donor transplant, which is a handy stem cell source that is also performed in CCHE transplant unit.

We are dedicated to providing comprehensive, compassionate and personalized care to our patients, stem cell donors, caregivers and families. Our collaborative approach to care ensures our patients have the best possible outcomes.

The pediatric Bone Marrow Transplant program at the Children’s cancer hospital of Egypt is one of the most experienced of its kind in the Middle East. We provide a full range of transplant options, including autologous, matched-related and cord transplants to treat different pediatric cancers including hematological malignancies and other solid tumors and our success rates meets the international averages.

Our team includes doctors and nurses who are leaders in pediatric stem cell transplantation. Our state-of-the-art stem cell transplant facility is designed specifically for children and teens undergoing stem cell transplant.

• Transplant rooms
• The unit consists of 9 single intensive care beds on the 2nd floor.
• All rooms are highly equipped meeting the international standards and monitored with an infection control team to ensure the highest safety for transplanted patients.
• The program offers transplant to 170 cases/year 100 cases of them are allogeneic


• Post-transplant clinics to follow our patients thoroughly and manage different complications in the post-transplant period e.g. chronic graft versus host disease.


• Apheresis unit on 2nd floor:
• Three blood component separator machines used for stem cell separation used in Allo- and Auto-transplant
• Laminar airflow hood with triple HEPA filters
• Cryopreservation room on 2nd floor:
• PBSC cryopreservation system: which include controlled rate freezer, liquid nitrogen (LN) supply tanks and LN storage system for PBSC bags
• Outpatient clinic and post-transplant FU:
• The transplant center is attached to an out-patient clinic.
• It should be possible for a patient to obtain specialist advice by telephone on a 24-hour basis.

Most commonly treated diagnosis:

Although most marrow transplants are for hematologic malignancies, the most common indications for allogeneic and autologous transplants differ:

1. Allogeneic BMT:
1. Acute lymphoblastic leukemia:
1. High-risk patients in first complete remission (CR1)
2. Low-risk patients in second complete remission (CR2)
2. Acute myeloid leukemia:
1. High-risk patients in first complete remission (CR1)
2. Low and Intermediate risk patients in second complete remission (CR2)
3. Chronic myeloid leukemia (CML): Accelerated and blastic phase as well as chronic phase not responding to TKI therapy
4. Juvenile Myelomonocytic Leukemia (JMML)
5. Myelodysplastic syndrome


2. Autologous BMT:

Since a marrow or stem cell source for allografting cannot always be found, autologous bone marrow (ABMT) or Peripheral blood stem cell transplantation (APBSCT) is also used as a method for treating a number of malignant disorders as:

1. Hodgkin’s disease:
1. Primary refractory
2. Relapsing
2. Non-Hodgkin’s lymphoma:
1. In second complete remission (CR2)
2. Primary refractory
3. Neuroblastoma (high-risk and relapsing cases):
1. Complete remission
2. Very good partial remission.
4. Extraocular Retinoblastoma
1. Complete remission
2. Very good partial remission.
5. Wilm’s tumor

24/7

1. Central Venous Line insertion.
2. Pre-transplant assessment.
3. Pre-transplant evaluation of hepatitis markers.
4. BMT pre-medications.
5. HSCT collection:
1. PBSC collection:
1. Donor/patient mobilization
2. Leukopharesis
3. Analysis of CD34 cells.
2. BM harvesting
6. BMT HSC infusion
7. Conditioning regimen
8. GVHD prophylaxis & Management.
9. Pre- and peri- transplant patient monitoring and supportive care