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Inherited and Genetic Disorders

Hematopoietic SCT in Iranian children 1991–2012

Abstract

This study presents the pediatric hematopoietic SCT (HSCT) activity in Iran between 1991 and 2012. Overall, 1105 fifteen-year-old or younger patients have undergone HSCT (975 allogeneic and 130 autologous). Annual HSCTs have been increasing steadily since 2007. HLA-matched siblings and other related donors were the main source of HSCs, although since 2008 a national HLA registry has been established to fill the gap for patients lacking a related donor. Inherited abnormalities of RBCs (45.88%), leukemias (27.6%) and BM failure syndromes (11.94%) constituted the majority of HSCTs during this period. Two-year overall survival and disease-free survival rates for all patients were 74.2% (95% confidence interval (CI): 71.6–77) and 66.3% (95% CI: 63.5–69.3), respectively. Leading cause of death in allogeneic group was TRM (165 deaths) and relapse caused the majority of deaths in the autologous group (39 deaths). All HSCTs from the beginning have been performed exclusively with TBI-free-conditioning regimens, which provides unique data for comparison with activities of other centers. Encouraging survival rates provide a basis for future studies on the extensive applicability of TBI-free-conditioning regimens in pediatric HSCT.

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References

  1. Lorenz E, Uphoff D, Reid TR, Shelton E . Modification of irradiation injury in mice and guinea pigs by bone marrow injections. J Natl Cancer Inst 1951; 12: 197–201.

    CAS  PubMed  Google Scholar 

  2. Storb R . History of pediatric stem cell transplantation. Pediatr Transplant 2004; 8: 5–11.

    Article  PubMed  Google Scholar 

  3. Vos O, Davids JA, Weyzen WW, Van Bekkum DW . Evidence for the cellular hypothesis in radiation protection by bone marrow cells. Acta Physiol Pharmacol Neerl 1956; 4: 482–486.

    CAS  PubMed  Google Scholar 

  4. Aljurf MD, Zaidi SZ, El Solh H, Hussain F, Ghavamzadeh A, Mahmoud HK et al. Special issues related to hematopoietic SCT in the Eastern Mediterranean region and the first regional activity report. Bone Marrow Transplant 2009; 43: 1–12.

    Article  CAS  PubMed  Google Scholar 

  5. Benchekroun S, Harif M, Madani A, Quessar A, Zafad S, Rachid R . Present and future of hematology and stem cell transplantation in Morocco. Bone Marrow Transplant 2008; 42: S106–S108.

    Article  PubMed  Google Scholar 

  6. Ghavamzadeh A, Alimogaddam K, Jahani M, Mousavi S, Iravani M, Bahar B et al. Hematopoietic stem cell transplantation in Iran: 1991 to 2008. Hematol Oncol Stem Cell Ther 2008; 1: 231–238.

    Article  PubMed  Google Scholar 

  7. Miano M, Labopin M, Hartmann O, Angelucci E, Cornish J, Gluckman E et al. Haematopoietic stem cell transplantation trends in children over the last three decades: a survey by the paediatric diseases working party of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant 2007; 39: 89–99.

    Article  CAS  PubMed  Google Scholar 

  8. Wachowiak J, Labopin M, Miano M, Chybicka A, Stary J, Sterba J et al. Haematopoietic stem cell transplantation in children in eastern European countries 1985-2004: development, recent activity and role of the EBMT/ESH Outreach Programme. Bone Marrow Transplant 2008; 41: S112–S117.

    Article  PubMed  Google Scholar 

  9. Yoshimi A, Suzuki R, Atsuta Y, Iida M, Lu DP, Tong W et al. Hematopoietic SCT activity in Asia: a report from the Asia-Pacific Blood and Marrow Transplantation Group. Bone Marrow Transplant 2010; 45: 1682–1691.

    Article  CAS  PubMed  Google Scholar 

  10. Rocha V, Locatelli F . Searching for alternative hematopoietic stem cell donors for pediatric patients. Bone Marrow Transplant 2008; 41: 207–214.

    Article  CAS  PubMed  Google Scholar 

  11. Baldomero H, Gratwohl M, Gratwohl A, Tichelli A, Niederwieser D, Madrigal A et al. The EBMT activity survey 2009: trends over the past 5 years. Bone Marrow Transplant 2011; 46: 485–501.

    Article  CAS  PubMed  Google Scholar 

  12. Pession A, Rondelli R, Paolucci P, Pastore G, Dini G, Bonetti F et al. Hematopoietic stem cell transplantation in childhood: report from the bone marrow transplantation group of the Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP). Haematologica 2000; 85: 638–646.

    CAS  PubMed  Google Scholar 

  13. Wiener LS, Steffen-Smith E, Fry T, Wayne AS . Hematopoietic stem cell donation in children: a review of the sibling donor experience. J Psychosoc Oncol 2007; 25: 45–66.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Hunger SP, Loh KM, Baker KS, Schultz KR . Controversies of and unique issues in hematopoietic cell transplantation for infant leukemia. Biol Blood Marrow Transplant 2009; 15: 79–83.

    Article  PubMed  Google Scholar 

  15. Atsuta Y, Suzuki R, Yoshimi A, Gondo H, Tanaka J, Hiraoka A et al. Unification of hematopoietic stem cell transplantation registries in Japan and establishment of the TRUMP System. Int J Hematol 2007; 86: 269–274.

    Article  PubMed  Google Scholar 

  16. Chen PM, Hsiao LT, Chen MH, Chang PM, Liu CY, Hong YC et al. Current status of hematopoietic stem cell transplantation in Taiwan. Bone Marrow Transplant 2008; 42: S133–S136.

    Article  PubMed  Google Scholar 

  17. Gratwohl A, Baldomero H, Frauendorfer K, Urbano-Ispizua A . EBMT activity survey 2004 and changes in disease indication over the past 15 years. Bone Marrow Transplant 2006; 37: 1069–1085.

    Article  CAS  PubMed  Google Scholar 

  18. Shamsi T, Hashmi K, Adil S, Ahmad P, Irfan M, Raza S et al. The stem cell transplant program in Pakistan—the first decade. Bone Marrow Transplant 2008; 42: S114–S117.

    Article  PubMed  Google Scholar 

  19. Ahmed SO, Ghavamzadeh A, Zaidi SZ, Baldomero H, Pasquini MC, Hussain F et al. Trends of hematopoietic stem cell transplantation in the Eastern Mediterranean region, 1984-2007. Biol Blood Marrow Transplant 2011; 17: 1352–1361.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Rihn C, Cilley J, Naik P, Pedicano AV, Mehta J . Definition of myeloid engraftment after allogeneic hematopoietic stem cell transplantation. Haematologica 2004; 89: 763–764.

    PubMed  Google Scholar 

  21. Atkinson K, Horowitz MM, Gale RP, Lee MB, Rimm AA, Bortin MM . Consensus among bone marrow transplanters for diagnosis, grading and treatment of chronic graft-versus-host disease. Committee of the International Bone Marrow Transplant Registry. Bone Marrow Transplant 1989; 4: 247–254.

    CAS  PubMed  Google Scholar 

  22. Schultz KR, Baker KS, Boelens JJ, Bollard CM, Egeler RM, Cowan M et al. Challenges and opportunities for international cooperative studies in pediatric hematopoeitic cell transplantation: priorities of the Westhafen Intercontinental Group. Biol Blood Marrow Transplant 2013; 19: 1279–1287.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Mohamed SY, Fadhil I, Hamladji RM, Hamidieh AA, Fahmy O, Ladeb S et al. Hematopoietic stem cell transplantation in the Eastern Mediterranean Region (EMRO) 2008-2009: report on behalf of the Eastern Mediterranean Bone Marrow Transplantation (EMBMT) Group. Hematol Oncol Stem Cell Ther 2011; 4: 81–93.

    Article  PubMed  Google Scholar 

  24. Bazarbachi A, Labopin M, Ghavamzadeh A, Giebel S, Al-Zahrani H, Ladeb S et al. Allogeneic matched-sibling hematopoietic cell transplantation for AML: comparable outcomes between Eastern Mediterranean (EMBMT) and European (EBMT) centers. Bone Marrow Transplant 2013; 48: 1065–1069.

    Article  CAS  PubMed  Google Scholar 

  25. Gratwohl A, Baldomero H, Frauendorfer K, Rocha V, Apperley J, Niederwieser D . The EBMT activity survey 2006 on hematopoietic stem cell transplantation: focus on the use of cord blood products. Bone Marrow Transplant 2008; 41: 687–705.

    Article  CAS  PubMed  Google Scholar 

  26. Hamidieh A, Kargar M, Jahani M, Alimoghaddam K, Bahar B, Mousavi SA et al. The outcome of allogeneic hematopoietic stem cell transplants without total body irradiation in pediatric patients with acute lymphoblastic leukemia: single centre experience. J Pediatr Hematol Oncol 2012; 34: 101–107.

    Article  PubMed  Google Scholar 

  27. Hamidieh AA, Alimoghaddam K, Jahani M, Bahar B, Mousavi SA, Iravani M et al. Non-TBI hematopoietic stem cell transplantation in pediatric AML patients: a single-center experience. J Pediatr Hematol Oncol 2012; 35: e239–e245.

    Article  Google Scholar 

  28. Hamidieh AA, Alimoghaddam K, Jahani M, Mousavi SA, Iravani M, Bahar B et al. Long-term results of non-fludarabine versus fludarabine-based stem cell transplantation without total body irradiation in Fanconi anemia patients. Hematol Oncol Stem Cell Ther 2011; 4: 109–115.

    Article  PubMed  Google Scholar 

  29. Hamidieh AA, Pourpak Z, Hashemi S, Yari K, Fazlollahi MR, Movahedi M et al. Fludarabine-based reduced-intensity conditioning regimen for hematopoietic stem cell transplantation in primary hemophagocytic lymphohistiocytosis. Eur J Haematol 2014; 92: 331–336.

    Article  CAS  PubMed  Google Scholar 

  30. Hamidieh AA, Pourpak Z, Hosseinzadeh M, Fazlollahi MR, Alimoghaddam K, Movahedi M et al. Reduced-intensity conditioning hematopoietic SCT for pediatric patients with LAD-1: clinical efficacy and importance of chimerism. Bone Marrow Transplant 2011; 47: 646–650.

    Article  PubMed  Google Scholar 

  31. Hamidieh AA, Pourpak Z, Yari K, Fazlollahi MR, Hashemi S, Behfar M et al. Hematopoietic stem cell transplantation with a reduced-intensity conditioning regimen in pediatric patients with Griscelli syndrome type 2. Pediatr Transplant 2013; 17: 487–491.

    Article  CAS  PubMed  Google Scholar 

  32. Lin KH . Pediatric hematopoietic stem cell transplantation in Taiwan. Transplant Proc 1998; 30: 3477–3480.

    Article  CAS  PubMed  Google Scholar 

  33. Rodriguez-Romo L, Gonzalez-Llano O, Mancias-Guerra C, Jaime-Perez JC, Gomez-Pena A, Ruiz-Arguelles G et al. Pediatric hematopoietic SCT in Mexico: recent activity and main problems. Bone Marrow Transplant 2010; 46: 607–609.

    Article  PubMed  Google Scholar 

  34. Elbjeirami WM, Abdel-Rahman F, Hussein AA . Probability of finding an HLA-matched donor in immediate and extended families: the Jordanian experience. Biol Blood Marrow Transplant 2012; 19: 221–226.

    Article  PubMed  Google Scholar 

  35. Aghajanian A . A new direction in population policy and family planning in the Islamic Republic of Iran. Asia Pac Popul J 1995; 10: 3–20.

    CAS  PubMed  Google Scholar 

  36. Lucarelli G, Andreani M, Angelucci E . The cure of thalassemia by bone marrow transplantation. Blood Rev 2002; 16: 81–85.

    Article  CAS  PubMed  Google Scholar 

  37. Gennery AR, Slatter MA, Grandin L, Taupin P, Cant AJ, Veys P et al. Transplantation of hematopoietic stem cells and long-term survival for primary immunodeficiencies in Europe: entering a new century, do we do better? J Allergy Clin Immunol 2010; 126: 602–10 e1-11.

    Article  PubMed  Google Scholar 

  38. Sevilla J, Fernandez-Plaza S, Diaz MA, Madero L . Hematopoietic transplantation for bone marrow failure syndromes and thalassemia. Bone Marrow Transplant 2005; 35: S17–S21.

    Article  PubMed  Google Scholar 

  39. Bacigalupo A, Socie G, Lanino E, Prete A, Locatelli F, Locasciulli A et al. Fludarabine, cyclophosphamide, antithymocyte globulin, with or without low dose total body irradiation, for alternative donor transplants, in acquired severe aplastic anemia: a retrospective study from the EBMT-SAA Working Party. Haematologica 2010; 95: 976–982.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Mitchell R, Nivison-Smith I, Anazodo A, Tiedemann K, Shaw PJ, Teague L et al. Outcomes of haematopoietic stem cell transplantation for inherited metabolic disorders: a report from the Australian and New Zealand Children's Haematology Oncology Group and the Australasian Bone Marrow Transplant Recipient Registry. Pediatr Transplant 2013; 17: 582–588.

    Article  CAS  PubMed  Google Scholar 

  41. Prasad VK, Kurtzberg J . Emerging trends in transplantation of inherited metabolic diseases. Bone Marrow Transplant 2008; 41: 99–108.

    Article  CAS  PubMed  Google Scholar 

  42. Boelens JJ . Trends in haematopoietic cell transplantation for inborn errors of metabolism. J Inherit Metab Dis 2006; 29: 413–420.

    Article  PubMed  Google Scholar 

  43. Aristei C, Santucci A, Corvo R, Gardani G, Ricardi U, Scarzello G et al. In haematopoietic SCT for acute leukemia TBI impacts on relapse but not survival: results of a multicentre observational study. Bone Marrow Transplant 2013; 48: 908–914.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We wish to acknowledge the contributions of all physicians, nursing staff, patients and their families and all who have made it possible to continue HSCT through many years.

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Correspondence to A A Hamidieh.

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Hamidieh, A., Behfar, M., Babaki, A. et al. Hematopoietic SCT in Iranian children 1991–2012. Bone Marrow Transplant 50, 517–522 (2015). https://doi.org/10.1038/bmt.2014.299

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