engleski

Specificities of Autologous Haematopoietic Stem Cell Transplantation in Children: A Single Centre Experience

Background: Autologous haematopoietic stem cell transplantation (AHSCT) is now an integral part of the treatment of high-risk solid tumours in children. However, specific characteristics and problems related to paediatric patients must be taken into account. Considering these tumours are rare, indications, efficacy and practical issues of autologous transplantation have been a topic of research and discussion. Results: We analysed 46 children with high-risk solid tumours and lymphomas, with a median age of 5.4 years who underwent AHSCT without tumour cell purging. Median follow-up of patients after AHSCT was 37.5 months. There were no lethal outcomes due to high-dose chemotherapy toxicity or transplantation-related consequences. 11 patients (23.9%) died while 35 (76.1%) out of 46 patients survived. Overall five-year survival of all transplanted patients was 73%. There was a significant difference in the survival of neuroblastoma patients compared to the remainder of solid tumour patients (82% vs. 38%, log-rank test X2=6.86, P<0.01). Unlike lymphoma and neuroblastoma patients, the worst survival rates were amongst patients with brain tumours and rhabdomyosarcoma. Patients in complete remission before the transplantation had more favourable survival rates than patients who had achieved partial remission (log-rank test X2=16.37, P<0.01). Conclusion: Our results confirm success of AHSCT in children with neuroblastoma and lymphomas in extending their survival. For other tumour patients and patients in partial remission before the transplantation, survival may be increased by introducing double AHSCT with post-transplant immunomodulatory therapy.

Autologous haematopoietic stem cell transplantation ; Children ; Solid tumours

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