617 - Outcomes of Stem Cell Transplantation in Children—Long Term Experience of a Single Centre

Abstract

Background: Haematopoietic stem cell transplantation (HSCT) provides curative treatment for a number of malignant and non-malignant disorders. We present single institutional data on HSCT outcomes in a large number of children. Patients and methods: Children (age ≤ 15 years) who underwent HSCT in the department of Haematology, Christian Medical College, Vellore, India between May 1989 and December 2016 were analyzed. Data was collected from individual medical records and department databases. Results: 858 children underwent 926 transplants (600 males and 326 female) with a median age of 8 years (range: 7 months to 15 years). Indications for HSCT included both non-malignant (n = 787; 84.9%) [mainly Thalassaemia major (n = 533) and aplastic anaemia (n = 135)] and malignant disorders (n = 139; 15.1%) [ALL (n = 64) and AML (n = 57)]. Donors were matched sibling or family donors in 789 (85.2%), matched unrelated donors in 68 (7.3%) and haplo-identical in 69 (7.5%). Graft source was bone marrow in 417 (45%), cord blood in 3 and peripheral blood stem cells (PBSC in 507 (54.7%). Engraftment occurred in 94.4% at a median of 16 days post HSCT. Grade ii-iv acute GVHD occurred in 34.2% and chronic GVHD in 39%. the 5 yr OS for the entire cohort is 71.4 + 1.6% with better survival among matched sibling donors (74.4 + 1.6%) compared to unrelated donors (56.4 + 6.7%) or haplo-identical donors (50.4 + 6.6%). The 5 yr OS has improved over time; 1989-1996 [5 yr OS of 64.1 + 5.4%], 1997-2006 [69.6 + 3.0%] and 2007-2016 [72.9 + 1.9%]. Conclusion: HSCT offers a good chance of cure in children with haematological disorders with 50% chance of cure with alternate donors.