Pediatric Stem Cell Transplant
Overview
Autologous and allogeneic stem cell transplantation are used to treat a wide spectrum of benigh hematological diseases (ex. severe aplastic anemia, beta-thalassemia major, congenital immunodeficiency disease), or malignant diseases (ex. acute leukemia, juvenile myelomoncytic leukemia, lymphoma, or malignant embryonal brain tumor or Ewing sarcoma) in pediatric patients. Being the first hospital treating patient with stem cell transplant in Taiwan in 1984, we are one of the top hospitals performing pediatric stem cell trasplants with good survival outcomes, which are comparable with those in western countries.
The stem cell sources include bone marrow, peripheral blood stem cell or cord blood; and the intensity of conditioning regimen varies from myeloabaltive to reduced intensity according to patients’conditon and the underlying disease. In selective patients with malignant tumors, tandem transplant or transplant from alternative donors (ex. haploidentical) will be applied to increase the disease-free survival. The excellent transplant results were presented in several famous international symposium and journals. In the past 10 years, we have treated 10-20 pediatric patients requiring transplant from Vietnam, Indonesia, Mainland China, and USA.
Features Summary
With hundreds of experiences in treating pediatric patients by stem cell transplant, we
- Treat patients with hematological diseases (acute relapsed/refractory leukemia, juvenile myelomonocytic leukemia at frontline, or SAA).
- Treat patients with inherited diseases (WAS, CGD, SCID, ALD, Gaucher disease, thalassemia major).
- Safely treat patients with malignant solid tumors (MB, ETMR, Stage IV NB, Ewing sarcoma) by single or tandem autologous transplant.
- Effectively and safely harvest sufficient peripheral blood stem cells for tandem transplant, even in children of low body weight.
Meticulously follow up long term survivors of pediatric patients receiving stem cell transplant throughout childhood to adulthood.
Procedure
For allogeneic transplant, HLA-compatible donors should be searched first. If the patient had an HLA-matched sibling, the transplant procedure will start with organ functioning evaluation in both donor and recipient in Taiwan. If an HLA-matched sibling was not available, international donor search in stem cell bank should be prioritized to reduce unnecessary stay or cost in Taiwan. Once donor is available, recipient should be admitted for detailed organ function evaluations in Taiwan. The whole transplant procedure takes 2-month hospitalization, which includes high dose chemotherapy, followed by stem cell infusion, peri-engraftment care and stem cell engraftment. The donor search in Taiwan Tzuchi Stem Cell Registry will require an additional charge. After transplant, a minimal stay for 4-6 months in Taiwan is required.
Notification
Potential complications include:
Nausea, vomiting.
Oral mucositis
Anemia, neutropenia, thrombocytopenia
Allergy to blood transfusion
Severe immunocompromise after transplant
Frequent infection, neutropenic fever
CMV, EBV reactivation
Bacterial or fungal infection
Engraftment syndrome
Sinusoidal obstruction syndrome
Acute or chronic graft versus host disease
Acute/transient renal and liver function impairment
A 3-month-old boy suffering from a rare hematological malignancy, juvenile myelomonocytic leukemia, came from Vietnam and received uneventful hematopoietic stem cell transplant from an HLA matched unrelated donor at the age of 8 months with good hematological recovery, and is disease free for 10 more years.
Successful sibling hematopoietic stem cell transplantation on a patient with severe aplastic anemia using the PBSC harvested from a sibling donor as young as 5 years of age who came from Indonesia during COVID-19 pandemics in 2020. The recipient returns to work with good physical status months after transplant.
Estimated Cost
For estimated medical costs, please contact International Medical Services Center.
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