Autologous stem cell transplantation for pediatric solid tumors in a resource-limited setting: a single-center experience of 15 years - Report - MDSpire
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Autologous stem cell transplantation for pediatric solid tumors in a resource-limited setting: a single-center experience of 15 years
Long-Term Outcomes of Autologous Stem Cell Transplantation for Pediatric Solid Tumors
Overview
This study evaluates the long-term outcomes of autologous stem cell transplantation (ASCT) in pediatric patients with solid tumors in a resource-constrained environment. The findings indicate a 3-year overall survival rate of 50.6% and event-free survival of 35.9%, highlighting the potential of ASCT in this demographic despite challenges in supportive care.
Background
Pediatric cancers have seen improved survival rates in developed countries, yet outcomes in low- and middle-income countries (LMICs) remain suboptimal. This study addresses the gap in data regarding ASCT for pediatric solid tumors in LMICs, where access to care and supportive infrastructure is limited. Understanding these outcomes is crucial for improving treatment strategies in resource-constrained settings.
Data Highlights
Parameter
Value
Median Age
6 years (IQR, 4-16)
3-Year OS
50.6% (95% CI: 36.8-62.9)
3-Year EFS
35.9% (95% CI: 23.6-48.3)
Median CD34+ Cell Dose
5.7 million/kg (IQR, 3.5-6.9)
Median Time to Neutrophil Engraftment
11 days (IQR, 9-12)
Key Findings
Out of 92 patients, 69.6% were male, with a median age of 6 years.
High-risk neuroblastoma (HRNB) was the most common diagnosis at 52.2%.
The median cryopreservation duration of stem cells was 16 days (IQR, 8-49).
Three-year overall survival rates varied by diagnosis: HRNB (48.5%), relapsed/refractory Ewing sarcoma (43.8%), and germ-cell tumors (56.3%).
Busulfan-melphalan conditioning showed better overall survival compared to carboplatin-etoposide-melphalan for HRNB and Ewing sarcoma (HR = 0.15, p=0.005).
Clinical Implications
The study provides valuable insights into the feasibility and outcomes of ASCT for pediatric solid tumors in LMICs. Clinicians should consider the specific challenges faced in these settings, including infection risks and supportive care limitations, when planning treatment.
Conclusion
ASCT demonstrates acceptable outcomes for high-risk or relapsed/refractory pediatric solid tumors in LMICs, suggesting its viability as a treatment option in these contexts.
