Hematopoietic stem cell transplantation has been successfully used to treat the pediatric
population with malignant and non-malignant
hematological diseases . This
paper reports the results up to 180 days after the
procedure of all unrelated
hematopoietic stem cell transplantations in pediatric
patients that were performed in one institution.
METHODS: A retrospective
review was performed of all under 18-year-old
patients who received unrelated
transplantations between 1995 and 2009. Data were analyzed using the log-rank test, Cox stepwise model, Kaplan-Meier
method , Fine and Gray model and Fisher's exact test.
RESULTS: This study included 118
patients (46.8%)
who received
bone marrow and 134 (53.2%)
who received
umbilical cord blood transplants . Engraftment occurred in 89.47% of the
patients that received
bone marrow and 65.83% of those that received
umbilical cord blood (p-value < 0.001). Both
neutrophil and
platelet engraftments were faster in the
bone marrow group. Acute
graft-versus-host disease occurred in 48.6% of the
patients without statistically significant differences between the two groups (p-value = 0.653).
Chronic graft-versus-host disease occurred in 9.2% of the
patients with a higher
incidence in the
bone marrow group (p-value = 0.007).
Relapse occurred in 24% of the 96
patients with malignant
disease with 2-year
cumulative incidences of 45% in the
bone marrow group and 25% in the
umbilical cord blood group (p-value = 0.117). Five-year overall
survival was 47%, with an average
survival time of 1207 days, and no significant differences between the groups (p-value = 0.4666).
CONCLUSION: Despite delayed engraftment in the
umbilical cord blood group,
graft-versus-host disease ,
relapse and
survival were
similar in both groups...