Bone marrow transplantation for children with acquired or congenital marrow failure

Bone marrow failure in children may result from congenital or acquired dise ases. Regardless of the etiology, prognosis depends upon the severity of im pairment of hematopoiesis. With supportive care alone, 80% of patients with acquired severe marrow failure used to die of bleeding, infection or other complications (Camitta et al., 1976, Blood, 48, 63-70). Recently, both bon e marrow transplantation, granulocyte colony stimulating factors and immuno suppression have greatly improved the outcome of children with marrow failu re. This paper reviews the current status of bone marrow transplantation fo r the treatment of children with severe aplastic anemia and related disorde rs. Recommendations are made regarding the optimal timing of marrow transpl antation in regard to the severity of disease and the availability of a rel ated or unrelated marrow donor.