Hematopoietic stem cell transplantation in childhood: report from the bonemarrow transplantation group of the Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP)

Background and Objectives. Transplantation of hematopoietic stem cells from different sources is being increasingly used to treat a variety of disease s in children. Transplant procedures and indications have changed considera bly during recent years. Monitoring of information about these changes is u seful for Interpretation of nationwide collected data. Design and Methods. Since 1985, Centers belonging to the AIEOP (Associazion e Italiana Ematologia Oncologia Pediatrica), performing hematopoietic stem cell transplants (HSCT) in children, and members of the AIEOP-Bone Marrow T ransplant (BMT) Group annually report data on their transplant activity to the AIEOP-BMT Registry employing specially prepared patient-oriented forms. Results. From January 1985 to December 1998, a total of 2,474 bone marrow ( BM), peripheral blood (PB) or umbilical cord blood (CB) transplants were re ported: 1,296 (52%) were allogeneic (Allo) and 1,178 (48%) autologous (Auto ) transplants. These transplants were performed in 19 Italian Centers on 2, 249 patients aged less than 17 years. Among Allo-transplants, 1,198 (92%) w ere performed using BM progenitor cells, whereas 49 (4%) used CB, 42 (3%) w ere PB, 4 BM plus PB, and 3 BM plus CB allografts. The transplants were per formed using HLA-identical sibling donors in 867 cases (67%) and alternativ e donors (i.e. partially-matched relatives or unrelated donors)in the remai ning 429 (33%) cases. Allogeneic transplants were performed on 786 (67%) pa tients with malignancy and on 395 (33%) patients with non-malignant disorde rs. In the last 6 years, the number of Allo-transplants per year exceeded t hat of Auto-transplants. Of the Auto-transplants, 775 (66%) were performed using BM, and 403 (34%) using PB alone or combined with BM hematopoietic st em cells. Indications for Auto-BMT were myelo-lympho-proliferative disorder s in 524 (49%) cases, solid tumor in 533 (50%) cases and non-malignant dise ase in 11 (1%) cases. In the last 5 years, the use of Re for autografts has increased from 7% to 70%. Interpretation and Conclusions. These data reflect the development and pres ent status of HSCT in Italy and provide a basis for patient counseling and health care planning. (C) 2000, Ferrata Storti Foundation.