Acute Lymphoblastic Leukemia Patient & Family Handbook

this have happened? Why, if we did everything as instructed, would the disease return?” Sadness and anger also may be the responses to the idea of having to undergo treatment again. Relapse can be even more complicated than the initial diagnosis, in part because the child and family have a better idea of what to expect. While struggling with intense feelings, you are in the position of having to learn about and decide on a new course of treatment. It is important to recognize that relapse, while frightening, does not mean your child will not be cured of the disease. It means that a new approach to treatment must be taken. n BONE MARROW TRANSPLANT (BMT) A bone marrow transplant (BMT), also known as stem cell transplant, may be one of the treatment options offered to your family if there is a relapse or it may be part of the treatment plan if your child has high- or very high-risk ALL. The purpose of a BMT is to destroy the relapsed leukemia cells and replace them with normal blood cells. Your child will first receive very high doses of chemotherapy and sometimes radiation therapy to the whole body to destroy all of the blood cells (both the healthy cells and the leukemia cells). Then new bone marrow will be infused, much like a blood transfusion. The new bone marrow may come from different sources and must be a good match for your child. The donor may be related to the child, such as a brother or sister (called a matched family donor ), or the donor may be someone who is not related to the child (an unrelated donor ). Many children’s cancer hospitals are using umbilical cord blood cells or peripheral blood stem cells as a cell source. BMT can be a difficult process to go through for a child and family. There may be side effects from the chemotherapy, radiation, or medicine used to help the child during and after transplant. Your BMT team will discuss the side effects and risks associated with BMT with you in detail.

n HOW CAN I WORK WITH MY CHILD’S HEALTHCARE TEAM? Many health professionals are involved in the care of children with cancer. Each person serves a valuable role in coordinating their care.

Your child’s care requires a team approach. As a parent, you are a major part of the team. Your input is important. You know your child better than anyone else. It is important to communicate openly with your child’s healthcare team. Be sure to question your child’s doctor or nurse when there is anything you are not sure about. It helps to write down questions as they come to mind.

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