The marrow ablative chemotherapy usually consists of one or more of the chemotherapy drugs active against neuroblastoma such as Cytoxan, melphalan, carboplatinum, VP-16, or thiotepa. The transplant is performed in the patient's hospital room. Although there are a number of potential complications associated with this procedure, the most common are infection and bleeding. Until the bone marrow engrafts and begins producing sufficient white blood cells, the patient is less able to neutralize bacteria, viruses and fungi that may enter the body through the nose, mouth or skin and cause infection. To reduce the risk of bleeding, patients are given infusions of platelets.
Platelets help blood clot.
Patients are usually able to produce sufficient platelets on their own four to six weeks following the infusion of stem cells, though some may require periodic platelet infusions for several months. An allogeneic BMT is an option for patients who have a brother or sister with a matching marrow type who can serve as a bone marrow donor. However, it also increases the risk of transplant related complications. In GVHD, the white blood cells in the donor's bone marrow that normally react against bacteria, viruses and other cells that do not belong in the donor's body, perceive the patient's body as foreign material. They begin attacking organs and tissues, impairing their ability to function.