Three Hundred and Fifty Cases of Pediatric Allogeneic Hematopoietic Stem Cell Transplantation: Single Center Study in Korea.

Background: Hematopoietic stem cell transplantation (HST) was first introduced to Korean children in 1983. Since then HST has been a curative method for pediatric malignant or non-malignant hematologic disorders and the number of children receiving HST’s has been increasing steadily.

Method: We analyzed three hundred and fifty cases of pediatric allogeneic hematopoietic stem cell transplantation between Nov. 1983 and Dec. 2003 in the Catholic Hematopoietic Stem Cell Transplantation Center of Korea.

Results: HLA-matched sibling bone marrow transplantations were performed in 206 cases (103 males, 103 females, median age 12 years) with median follow-up of 73 months. The 5-year event-free survival (EFS) of ALL and AML was 70.5 % and 67.22 %, respectively. The 5-year EFS of severe aplastic anemia was 90.9 %. The 5-year EFS of CML/MDS and rare hematologic diseases was 65.5 % and 90.0 %, respectively. Eighty-one children (56 males, 25 females, median age 9 years) underwent unrelated bone marrow transplantation (UBMT), 42 (27 males, 15 females, median age 5 years) cord blood transplantation (CBT) and 21 (14 males, 7 females, median age 8 years) familial haploidentical HST (FHT). Three-year EFS of UBMT, CBT and FHT was 55.6 %, 48.0 % and 38.0 %, respectively.

Conclusion: HLA-matched sibling allogeneic BMT showed better survival in children with hematopoietic stem cell disorders. Recently, transplants using alternative stem cell sources are increasing due to the lack of suitable sibling donors and continued efforts for reducing transplant-related complications are warranted for improved survival.