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Long IslandSuffolk

How Julianna's procedure will work

Julianna Buttner with her twin sister, Jessica, and

Julianna Buttner with her twin sister, Jessica, and their parents, Michael and Lynda. Jessica will donate bone marrow in an effort to beat back Julianna?s leukemia. (Jan. 7, 2010) Credit: Newsday / Mahala Gaylord

Julianna Buttner faces arduous months of medical treatment and monitoring as she adapts to life with stem cells derived from her sister's bone marrow. The process poses only a little discomfort for Jessica, doctors say. Here are the steps that lie ahead:

CONDITIONING. The regimen: A week of radiation and chemotherapy to destroy leukemic cells and inactivate Julianna's immune system.

'DAY ZERO.' This is the day donated cells are received. Day Zero usually occurs one to two days after the final conditioning treatment.

DONOR CELLS. A donor can provide cells in one of two ways, either through having them withdrawn from the pelvis or by taking medication for five days to recruit stem cells into the blood stream. In that case, the cells are withdrawn from an arm and passed through a machine to isolate those to be used for the recipient.

INFUSION. The transplant itself is called an infusion, and is similar to a blood transfusion. The length of time it takes to receive it depends on the volume being infused. For a small child, it may take about an hour.

MONITORING. Following the infusion, doctors begin an intense monitoring process that lasts for several months. Even after Julianna is released from the hospital she will have to remain nearby for daily tests.

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