Hematopoietic stem cell transplantation hsct refers to a procedure in which hematopoietic stem cells are infused to restore bone marrow function in cancer patients who receive bonemarrowtoxic doses of cytotoxic drugs, with or without wholebody radiation therapy. Rsv infection without ribavirin treatment in pediatric. Mscs in pediatric hematopoietic stem cell transplantation. The aim of this singlecenter retrospective analysis was to characterize viral infections in the first year after hsct, to investigate risk factors and to study the impact of viral infections on. Respiratory virus infections in pediatric hematopoietic stem.
Pediatric hematopoietic stem cell transplantation and the. May 16, 2016 rsv infection without ribavirin treatment in pediatric hematopoietic stem cell transplantation. Assess comparative benefits and harms of hematopoietic stem cell transplantation hsct versus standard therapies or disease natural history in pediatric age. Jun 01, 2014 the stem cell source which is considered as a classical source for hematopoetic stem cell transplantation is bone marrow. Childhood hematopoietic cell transplantation pdqhealth. The indications for hematopoietic stem cell transplantation hsct depend on the patients medical condition, the therapeutic objectives, and the availability and source of stem cells table 1. Pdf on sep 1, 2005, kleebsabai sanpakit and others published overview in pediatric hematopoietic stem cell transplantation find, read and cite all the research you need on researchgate. The multipotent hematopoietic stem cells required for this procedure are usually obtained from the bone marrow, peripheral blood, or umbilical cord blood of a related or unrelated donor. Hematopoietic stem cell transplantation hsct is used to treat a variety of hematological and congenital diseas es. Hematopoietic stemcell transplantation in the pediatric. First report of pediatric hematopoietic stem cell transplantation. Hematopoietic stem cell transplantation is approved for use in treating some types of cancer and is an experimental treatment for autoimmune diseases. Ema recommendation for the pediatric indications of.
Hematopoietic stem cell transplantation hsct, also known as bone marrow transplantation and peripheral blood stem cell transplantation, involves the collection of cells from bone marrow, peripheral blood, or umbilical cord blood. Pdf hematopoietic stem cell transplantation researchgate. Viral reactivation occurs frequently in the context of immunodeficiency and immunosuppression after allogeneic hematopoietic stem cell transplantation allohsct and can cause severe complications. The image below illustrates an algorithm for typically preferred hematopoietic stem cell transplantation cell. Bone marrow transplantation is called hematopoetic stem cell transplantation hsct, since peripheral blood and umbilical cord blood can also. Departments of oncology and pediatrics, university of calgary, calgary, alberta, canada. Children with highrisk acute lymphoblastic leukemia in first complete remission can benefit from allogeneic hematopoietic stem cell transplantation. To overcome this, the national marrow donor program nmdp was started in the 1980s, and it remains a major source of hematopoietic stem cells hscs for transplantation. Hematopoietic stem cell transplantation in children and adolescents. A cohort of 37 pediatric recipients of allogeneic hsct was monitored prior to hsct, at the time point of hsct, and posthsct median followup time 5. The two most widely used sources of hematopoietic stem cells for allogeneic transplants in pediatric practice are bone marrow bm and cord blood cb. Outcomes of processing of bone marrow harvests for.
The remarkable improvement in the prognosis of children with acute lymphoblastic leukemia all has been mainly achieved through the administration of riskadapted therapy, including allogeneic hematopoietic stem cell transplantation hsct. An overview tracy robinson, rn mn, conc clinical nurse specialist manitoba blood and marrow transplant program. Section of pediatric oncologybmt, alberta childrens hospital. Childhood hematopoietic cell transplantation involves the infusion of blood stem cells into a patient to reconstitute the blood system. Transplant of bone marrow and cord blood hematopoietic. Autologous hematopoietic stem cell transplantation hsct has been used to treat severe and refractory autoimmune diseases ads in children and adults for more than 15 years. Rationale for hematopoietic stem cell transplantation. Patients ranging in age from 5 months to 18 years received hematopoietic stem cell transplantation for benign or malignant indications. Jan 25, 2012 adenovirus adv infections are a major cause of morbidity and mortality in patients undergoing hematopoietic stem cell transplantation hsct. To describe the hematopoietic stem cell transplantation hsct activities for children in the eastern mediterranean em region, data. The success of treating a wide variety of pediatric diseases with hsct, hematologic malignancies in particular, has resulted in an increased number of long. Hematopoietic stem cell transplantation for children with. Hematopoietic stem cell transplantation an overview.
Our center uses a fludarabine and busulfanbased regimen, with a preference for bone marrow over peripheral blood stem cells to hopefully reduce the graftversushost disease gvhd risk. Persistent thrombocytopenia is a common complication after allogeneic hematopoietic stem cell transplantation hsct. Since the discovery of this procedure in the early 1960s as a cure for hematologic cancer and both congenital and acquired diseases of the hematopoietic system fig. Cb kits, approved by the food and drug administration for enrichment of mononuclear cells in cord blood units for hematopoietic transplantation. Allogeneic hsct uses stem cells derived from a donor. Hematopoietic stem cell transplants, including peripheral blood, bone marrow, and cord blood transplants are used most often to treat cancers affecting the blood or immune system.
The use of hematopoietic stem cell transplantation hsct in the treatment of children afflicted with many potentially fatal malignant and nonmalignant diseases is well recognized. Early and late complications following hematopoietic stem. Hematopoietic stem cells american academy of pediatrics. Acute kidney injury in pediatric patients receiving. Sep, 2019 monitoring of the host immune system and intestinal microbiome in hematopoietic stem cell transplantation hsct. While the use of thrombopoietin receptor agonists was retrospectively investigated in adults, data in pediatric posttransplant thrombocytopenia are lacking. The determinant for adequacy of the collected bone marrow is the number of nucleated cells. The use of hematopoietic stem cell transplantation hsct as a therapeutic. Hematopoietic stem cell transplant activity in pediatric cancer. Hand book for pediatric hematopoietic stem ce ll transplantation bone marrow transplant program lucile packard childrens hospital stanford university medical center michael d. Hematopoietic stem cell transplantation hsct has been an effective method for treating a wide range of malignant or nonmalignant disorders. Transplantation before the age of 2 years before the onset of irreversible neurological decline, favorably alters the natural history of the disease.
Rsv infection without ribavirin treatment in pediatric hematopoietic stem cell transplantation. Pdf haematopoietic stem cell transplantation trends in children. Transfusion support issues in hematopoietic stem cell. Bone marrow stem cells may be obtained from the transplant recipient i. Hsct with cells from the bone marrow of a hlaidentical sibling used in scd has a low mortality risk, high cure rate, and high eventfree survival rate after a median followup of 56 years. We analyzed the outcome of 211 children with highrisk acute lymphoblastic leukemia in first complete. Allogeneic hematopoietic stem cell transplantation allohsct has become increasingly used as a therapeutic treatment for several pediatric conditions, however the longterm mental health. Hematopoietic stem cell transplantation in primary.
In 2006, the center for international blood and marrow. Hematopoietic stem cell transplantation hsct is one of a range of therapeutic options available to patients suffering from various diseases. Viral reactivations following hematopoietic stem cell. Hematopoietic stem cell transplant hsct is the treatment of choice for patients with severe forms of mps i. Hematopoietic stem cell transplantation hsct is a potentially curative treatment for multiple malignant and nonmalignant diseases. In case of an autologous hsct, patients receive their own stem cells after myeloablation before extraction. Hematopoetic stem cell transplantation in children ncbi.
Pdf pediatric hematopoietic stem cell transplantation. Pediatric hematopoietic stem cell transplantation in china. Aug 26, 2010 rationale for hematopoietic stem cell transplantation how transplantation works. Hematopoietic stem cell transplantation in pediatric acute. Hand book for pediatric hematopoietic stem cell transplantation. Abdominal complications following hematopoietic stem cell. Allogeneic hematopoietic cell transplantation is an important and potentially curative treatment option for a wide variety of malignant and nonmalignant disorders. Despite being associated with a high risk of early and longterm complications, it is often. Hsct procedure involves important ethical and legal aspects that can occur at every phase of the procedure. It has been difficult in humans to document adequately that the number of hematopoietic stem cells transplanted will actually make a difference in terms of longterm outcome.
It has been in use for the past 50 years, and various aspects of the treatment have changed significantly over time, including the conditioning regimen, the source of stem cells and the general management strategies. Hct is a multistep process including many treatments that can cause renal insults, such as conditioning regimens composed of intensive chemotherapy or radiation, nephrotoxic immunosuppressive agents, and prophylactic or therapeutic anti. Human pluripotent stem cells hpscs represent a promising source of patientspecific cells for disease modeling, drug screens, and cellular therapies. Eltrombopag for thrombocytopenia following allogeneic. Pdf this paper describes the trends in haematopoietic stem cell transplantation hsct activity for children in europe over the last three decades. Evolving hematopoietic stem cell sources, less toxic conditioning regimens, and. Peripheral blood stem cells are less commonly used in pediatric hsct.
Pdf more than 25000 hematopoietic stem cell transplantations hscts are performed each year. Bacteremia in pediatric patients with hematopoietic stem cell. Mar 10, 2020 ema recommendation for the pediatric indications of plerixafor mozobil to enhance mobilization of hematopoietic stem cells for collection and subsequent autologous transplantation in children with lymphoma or malignant solid tumors. To evaluate the use of molecular adv testing in hsct at our institution and identify risk factors for adv viremia and disease, we performed a retrospective cohort study of all hsct recipients who had undergone adv polymerase chain reaction testing over. Complications of autologous hematopoietic stem cell. Aug 06, 2018 hematopoietic stem cell transplantation hsct involves the intravenous iv infusion of autologous or allogeneic stem cells to reestablish hematopoietic function in patients whose bone marrow or immune system is damaged or defective. The duration and specificity of transfusion support for patients receiving hsct depends on the disease, the source of the stem cells, the preparative regimen applied prior to transplantation, and patient factors during the. Hematopoietic stem cell transplantation hsct refers to a procedure in which hematopoietic progenitor cells, including repopulating stem cells, are infused to restore bone marrow function in patients. Allogeneic bm grafts were processed using prepacyte. Hand book for pediatric hematopoietic stem ce ll transplantation. Many donors for smaller children are consistently larger. Respiratory infections in hsct patients have been attributed to bacteria, fungi and other opportunistic pathogens 3, 4.
Risk factors for molecular detection of adenovirus in. Hematopoietic stem cell transplantation hsct indications and practices have changed significantly over the last 20 years. Nov 28, 2017 acute kidney injury aki is a welldescribed complication after hematopoietic cell transplantation hct, affecting 20% to 84% of transplant recipients 14. Hematopoietic stem cell transplantation hsct is an important treatment option for children with severe and refractory sickle cell disease scd with debilitating clinical complications. However, the inability to derive engraftable human hematopoietic stem and progenitor cells hspcs has limited their characterization to in vitro assays. Bone marrow is collected from the posterior iliac crest under general anesthesia.
Fertility preservation issues in pediatric hematopoietic stem cell transplantation. Autologous stem cells come from the person who will be. Oct 01, 2001 respiratory infections are a significant source of morbidity and mortality in the hematopoietic stem cell transplant hsct recipient 1, 2. Hematopoietic stem cell transplantations for dock8 deficiency have largely been with myeloablative or reduced intensity regimens. Jun 26, 2017 hematopoietic stem cell transplantation is approved for use in treating some types of cancer and is an experimental treatment for autoimmune diseases. Specific gut microbiome members are associated with distinct. Get detailed information about autologous and allogeneic transplant, hla matching, preparative regimens, and complications in this summary for clinicians. Hematopoietic stem cell transplantation in children and.1438 929 1134 1051 80 164 1404 911 1068 833 1192 171 148 408 432 839 1487 1600 920 756 43 954 654 760 488 905 259 707 1046 1053 999 1383 161 749 487 192 1366