Stem Cell Transplantation in children: A single-center experience in Saudi Arabia

Abstract

Introduction: Bone marrow transplantation (BMT) has frequently considered as a curative treatment for children with serious hematological and malignant disorders. The aim of this study was to determine the indication, frequencies of transplant-related morbidity, and outcome at our tertiary health care facility. Materials and Methods: We retrospectively analyzed the clinical, laboratory, and outcome data of all 131 pediatric patients consecutively underwent BMT between 2005 and 2014. SPSS package software version 20.0 (IBM, Chicago, IL, USA) was used for statistical analysis and Kaplan-Meier curve were constructed for overall survival (OS) and event free survival (EFS), and compared according to type of BMT, impact of graft-versus-host disease (GVHD), and cytomegalovirus (CMV) reactivation on survival function were evaluated. Results: The mean age of the study population at the time of transplant was 6.5 ± 4 years. Eighty-five (64.9%) were males and 46 (35.1%) were females. Majority of patients had nonmalignant hematological disorder (n = 51, 38.2%) followed by hematological malignancy (n = 50; 38.2%) and solid tumors (n = 30; 22.8%). Most of the patients received allogeneic transplant (n = 92; 70.2%) and remaining received autologous transplant (n = 39; 29.8%). Acute and chronic GVHD was observed in 26 (19.8%) and (6.9%) cases, respectively. Most of the patients were engrafted (n = 109; 83.2%). CMV reactivation was observed in 38 patients (29%); out of them majority were asymptomatic (n = 35/38; 92.1%) and in most of cases CMV were resolved (n = 35/38; 92.1%) with antigenemia-guided preemptive therapy with ganciclovir. OS and EFS rate were 69.5% and 59.6%, respectively. OS time was 35.5 months and EFS time was 31.6 months with median duration of follow-up of 72 months. Conclusions: The results of the pediatric BMT program at our institution have been comparable to those reported in the literature as far as transplant-related morbidity and mortality is concerned.