Hematopoietic SCT in Iranian children 1991–2012

Abstract

This study presents the pediatric hematopoietic SCT (HSCT) activity in Iran between 1991 and 2012. Overall, 1105 fifteen-year-old or younger patients have undergone HSCT (975 allogeneic and 130 autologous). Annual HSCTs have been increasing steadily since 2007. HLA-matched siblings and other related donors were the main source of HSCs, although since 2008 a national HLA registry has been established to fill the gap for patients lacking a related donor. Inherited abnormalities of RBCs (45.88%), leukemias (27.6%) and BM failure syndromes (11.94%) constituted the majority of HSCTs during this period. Two-year overall survival and disease-free survival rates for all patients were 74.2% (95% confidence interval (CI): 71.6-77) and 66.3% (95% CI: 63.5-69.3), respectively. Leading cause of death in allogeneic group was TRM (165 deaths) and relapse caused the majority of deaths in the autologous group (39 deaths). All HSCTs from the beginning have been performed exclusively with TBI-free-conditioning regimens, which provides unique data for comparison with activities of other centers. Encouraging survival rates provide a basis for future studies on the extensive applicability of TBI-free-conditioning regimens in pediatric HSCT.

Outcome Analysis of Pediatric Patients with Acute Lymphoblastic Leukemia Treated with Total Body Irradiation–Free Allogeneic Hematopoietic Stem Cell Transplantation: Comparison of Patients with and Without Central Nervous System Involvement

“…However, TBI is associated with adverse effects on the cardiopulmonary and renal systems, as well as an increased risk of the development of new malignancies, endocrinopathies, cognitive impairments, and developmental abnormalities in pediatric patients [4][5][6][7][8][9]. Thus, in some transplantation settings, TBIfree conditioning regimens have been used, mainly to minimize the delayed complications of irradiation and partly because of limited hospital facilities [10][11][12][13][14].…”

Parents’ experiences of living with a child with cancer undergoing hematopoietic stem cell transplantation: a qualitative content analysis study

“…In Iran, pediatric HSCT began in 1991, initially serving both pediatric and adult patients in a shared ward. However, in 2007, separate units were established for pediatric and adult HSCT, with patients aged 15 or younger directed to the pediatric ward ( Hamidieh et al, 2015 ). Although there are no accurate statistics on pediatric HSCTs in Iran, numerous pediatric HSCT centers now operate across Iran.…”