Infants show improving survival after hematopoietic cell transplantation despite high rates of critical care admission
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By
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Shaikha Alqahtani
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Fabiana Cacace
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Beiyu Liu
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Hwanhee Hong
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Erika Summers
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Lauren Stafford
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Brittany Paige DePriest
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Carmem Bonfim
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Timothy A. Driscoll
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Jennifer Jaroscak
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Shatha Yousef
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Joanne Kurtzberg
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Kris M. Mahadeo
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July 14, 2026
Clinical Scorecard: Survival Rates in Infants Improve Following Hematopoietic Cell Transplantation Despite Elevated Critical Care Admissions
At a Glance
| Category | Detail |
|---|
| Condition | Hematopoietic Cell Transplantation in Infants |
| Key Mechanisms | Increased sensitivity of developing organs, rapid clinical deterioration, and limited predictive data for critical care needs. |
| Target Population | Infants undergoing allogeneic hematopoietic cell transplantation (HCT) for non-malignant inherited disorders and high-risk hematologic malignancies. |
| Care Setting | Single center retrospective study evaluating outcomes in infants post-HCT. |
Key Highlights
- 41% of infants required critical care support within 100 days post-HCT, primarily for respiratory distress.
- Overall survival rates were 85.9% at 100 days and 73.5% at 1 year post-HCT.
- Mortality risk was significantly higher in infants requiring critical care, especially with invasive mechanical ventilation.
Guideline-Based Recommendations
Diagnosis
- Infants with inherited metabolic disorders and acute leukemias are common indications for HCT.
Management
- Close monitoring for clinical decompensation is essential due to rapid deterioration in infants.
Monitoring & Follow-up
- Vigilant assessment of respiratory signs and behavioral cues is critical for early intervention.
Risks
- Increased risk of transplant-related morbidity and mortality due to immature organ systems.
Patient & Prescribing Data
Infants aged 0-12 months undergoing HCT.
Advancements in HCT techniques and critical care have improved survival rates over the last decade.
Clinical Best Practices
- Early identification of infants at high risk for critical care admission is crucial.
- Monitoring for subtle signs of clinical deterioration is necessary for timely intervention.
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