Autologous hematopoietic stem cell transplantation (auto-HSCT) in children in Poland: 2021 indications and practice

Abstract

Unlike in adults, the number of pediatric autologous hematopoietic stem cell transplants (HSCT) has decreased in last years. This is because of changing indications for this type of treatment and new therapies available in recent years. Polish pediatric HSCT centers have followed the published recommendations of the Polish Pediatric Hematopoietic Stem Cell Transplantation Group, which are generally based on European Society for Blood and Marrow Transplantation indications. Differences are observed in obtaining autologous hematopoietic stem cells from children compared to adults in terms of the timing of the scheduled harvest and technical aspects of the harvesting procedure. As a result, stem cell harvesting in pediatric populations involves more medical professionals, and requires more time and more financial resources compared to adults. Pediatric autologous stem cell transplantation in neuroblastoma and Ewing’s sarcoma has confirmed efficacy. Autologous cell harvesting in young children established in autologous transplant procedure is now increasingly used in apheresis of lymphocytes for approved CAR-T cell therapies in relapsed/resistant leukemia and lymphoma. Recent studies suggest that cell-based immunotherapy is a potential treatment for refractory or relapsed pediatric solid tumors.